Clinical visual perimetry underestimates peripheral field problems in older adults

Academic Article

Abstract

  • 1. Older individuals frequently report difficulty in everyday activities requiring the use of peripheral vision. However, standard perimetry measurements commonly reveal only a minor age-associated loss in the visual field. 2. The relationship between older patients' reported problems in these everyday activities and visual field measurements was addressed by testing both young and older observers on three tasks: Goldmann perimetry, Octopus automated perimetry and performance on a task to assess the 'functonal' of 'useful' field of view. This task consisted of visual localization of a target under conditions designed to simulate the types of situations older indidviduals describe as difficult. 3. Each patient's age and performance on all three tasks were entered into a hierarchical regression analysis as potential predictors for the frequency of reported difficulties on visual tasks relating to visual search, mobility, and speed of visual processing (as assessed by survey questions). only performance on the visual localization task proved to be a significant predictor for survey responses related to these activities. Performance on the localization task showed specifity as a predictor in that it did not predict other age-related difficulties such as light sensitivity and susceptebility to glare. 4. Thus standard perimetric techniques underestimate the severity of many older adults' functional loss in the visual field. While older adults typically show some sensitivity losses throughout the field, assessments of functional vision with our task reveal a dramatic (3-fold) reduction in the visual field for many older individuals relative to their younger counterparts. Assessments of the useful field of view, along with standard clinical evaluation, may help to delineate the visual functions necessary for the performance of routine activities dependent on peripheral vision, such as driving.
  • Published In

  • Vision Research  Journal
  • Author List

  • Ball K; Owsley C; Beard B
  • Start Page

  • 113
  • End Page

  • 125
  • Volume

  • 5
  • Issue

  • 2