Perimetry: a change in the rate of progress?

A look at the current utility and limitations of conventional perimetry and ways in which the technique might be improved upon.

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Introduction 

Perimetry is the measurement of the visual field, and although perimetric techniques are most commonly used for the identification and following of glaucoma, they are also used in the investigation of neurological conditions such as optic neuritis, as well as retinal lesions and vascular problems. Traditionally, clinical techniques have been used to identify anomalies of the visual field, both in terms of its extent and its sensitivity, but recent findings from basic science studies point to the possibility of visual recovery in neurodegenerative conditions, if subtle premorbid changes in retinal cells are identified and treated early. Therefore, we may soon be faced with a new challenge for perimetry: to identify improvements in visual function in response to therapy. Few would doubt that visual field tests play a vital role in the diagnosis and management of blinding eye disease in the primary care setting. After all, optometrists are concerned with how people see, and treatments for eye disease are aimed at preserving vision, which needs to be quantified with accuracy and precision. However, even the gold-standard test has several well-known limitations, which make it difficult to understand truly the nature of some diseases and to identify changes of vision in patients.

This special feature article will consider the utility and limitations of conventional perimetry in 2016, as well as possible ways in which the technique might be improved upon in the future. It will include a discussion of research into optimal test paradigms and statistical methods aimed at identifying changes in vision from clinical data. 

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