Interpreting Visual Field Reports

Reliability and Test Quality

The American Academy of Ophthalmology recommends that fixation losses should be less than 20%, indicating the patient maintained a steady gaze 1
The American Academy of Ophthalmology suggests that false positives should be less than 15%, indicating the patient didn't respond when no stimulus was presented 1
The American Academy of Ophthalmology states that false negatives should be less than 33%, indicating the patient responded to dimmer stimuli but missed brighter ones 1
Unreliable tests require repeat testing before making treatment decisions, as stated by the American Academy of Ophthalmology 1, 2

The American Academy of Ophthalmology defines arcuate scotomas as nerve fiber bundle defects following the arcuate pattern of retinal nerve fibers, which is a characteristic of glaucomatous defects 3, 4
The American Academy of Ophthalmology describes nasal steps as defects that cross the vertical meridian, which is a characteristic of glaucomatous defects 3, 4
The American Academy of Ophthalmology states that homonymous hemianopsia is a loss in the same half of both visual fields, indicating chiasmal or post-chiasmal damage 6, 7
The American Academy of Ophthalmology describes bitemporal hemianopsia as a loss in the temporal fields of both eyes, suggesting chiasmal lesion 6, 7

The American Academy of Ophthalmology recommends using automated static threshold perimetry (SAP) with white-on-white stimuli as the gold standard for evaluating visual fields 1, 2
The American Academy of Ophthalmology states that normal values for threshold sensitivity are typically 30-35 dB in the central field, decreasing peripherally 1, 2

The American Academy of Ophthalmology recommends comparing the patient's results to an age-matched normal database to determine total deviation 1, 2
The American Academy of Ophthalmology states that pattern deviation corrects for overall depression, highlighting localized defects 1, 2

The American Academy of Ophthalmology recommends using mean deviation (MD) to measure overall field depression, with negative values indicating loss 1, 2
The American Academy of Ophthalmology states that pattern standard deviation (PSD) measures irregularity, with elevated values indicating localized defects 1, 2
The American Academy of Ophthalmology recommends using visual field index (VFI) to measure the percentage of normal field remaining, weighted toward central vision 1, 2

The American Academy of Ophthalmology categorizes the severity of glaucomatous damage as mild, moderate, or severe, based on visual field abnormalities and optic nerve/RNFL abnormalities 3, 4
The American Academy of Ophthalmology states that mild damage is characterized by normal visual field with optic nerve/RNFL abnormalities 4
The American Academy of Ophthalmology states that moderate damage is characterized by visual field abnormalities in one hemifield not within 5 degrees of fixation 4
The American Academy of Ophthalmology states that severe damage is characterized by visual field abnormalities in both hemifields and/or loss within 5 degrees of fixation 4