The College of Optometrists

If a patient's unaided near vision is say N24 at 50cm would it still be "correct" to do confrontation/gross perimetry at the suggested 33cm away from the patient. My target is a red 15mm target and i've always done it at approx 33cm from patient.

When my supervisor read my case records he said that I shouldn't do it that close if the pxs unaided vision was recorded further away. I thought it was OK to do it closer as it is just a detection test.

Anyone got any thoughts on this?

I have thought about this - I suppose both of you are correct. 15mm is not much between friends really. I was wondering how sensitive doing a confrontation with a 15mm target at a px with poor near va is (at any distance)?

I suupose you had done an auto plot centrally. And her peripheral fields I suppose are okay.

I wonder what your care plan was? and what the problem was

N24 at 50cm is referring to what the patient can do using the macula, not the peripheral retina. You can get a fairly accurate result with even acuities of 1/60 from extensive ARMD. The target you are using is not a detailed target, so ignore visions (to a large extent) when deciding whether to test peripheral fields.

My suggestion would be to continue testing peripheral fields on all your patients, if only untill you get to your exams. Maybe you will see the benefit and continue after you are registered. I still so sometimes.