Diffuse visual field loss and glaucoma. 1994

P Asman, and A Heijl
Department of Ophthalmology, Malmö General Hospital, Sweden.

It is often claimed that general reduction, or diffuse loss, of perimetric sensitivity is an early sign of glaucoma. Our clinical experience and the results of a few other studies led us to believe otherwise. To investigate factors associated with diffuse field loss we reviewed 4222 Humphrey 30-2 threshold tests from 1582 eyes of 862 patients followed at our department. Most of these patients had ocular hypertension or glaucoma. Each field test was evaluated with the Glaucoma Hemifield Test of the Statpac 2 program. The Glaucoma Hemifield Test classifies field test results as within or outside normal limits regarding localized field loss and general shifts in sensitivity. General reduction of sensitivity without concomitant localized loss was found in 117 tests from 81 eyes of 69 patients. Corresponding patient records were found for 60 eyes of 60 patients. Media opacities or miotic therapy were noted in 46 eyes (77%), 10 eyes (17%) had end-stage field loss, and in 2 eyes (3%) other non-glaucomatous ocular pathology explained the diffuse loss of sensitivity. Thus, general reduction of differential light sensitivity as an isolated finding was almost always associated with reasons other than early to moderate glaucoma in this material mainly consisting of patients with glaucoma or increased intraocular pressure. Since only 2 out of the 1582 eyes had general reduction of sensitivity that was not explained by non-glaucomatous reasons, we conclude that purely diffuse field loss was not a sign of glaucoma.

UI MeSH Term Description Entries
D008027 Light That portion of the electromagnetic spectrum in the visible, ultraviolet, and infrared range. Light, Visible,Photoradiation,Radiation, Visible,Visible Radiation,Photoradiations,Radiations, Visible,Visible Light,Visible Radiations
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009798 Ocular Hypertension A condition in which the intraocular pressure is elevated above normal and which may lead to glaucoma. Glaucoma, Suspect,Hypertension, Ocular,Glaucomas, Suspect,Hypertensions, Ocular,Ocular Hypertensions,Suspect Glaucoma,Suspect Glaucomas
D005260 Female Females
D005901 Glaucoma An ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. The consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (Dictionary of Visual Science, 4th ed) Glaucomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012684 Sensory Thresholds The minimum amount of stimulus energy necessary to elicit a sensory response. Sensory Threshold,Threshold, Sensory,Thresholds, Sensory
D014786 Vision Disorders Visual impairments limiting one or more of the basic functions of the eye: visual acuity, dark adaptation, color vision, or peripheral vision. These may result from EYE DISEASES; OPTIC NERVE DISEASES; VISUAL PATHWAY diseases; OCCIPITAL LOBE diseases; OCULAR MOTILITY DISORDERS; and other conditions (From Newell, Ophthalmology: Principles and Concepts, 7th ed, p132). Hemeralopia,Macropsia,Micropsia,Day Blindness,Metamorphopsia,Vision Disability,Visual Disorders,Visual Impairment,Blindness, Day,Disabilities, Vision,Disability, Vision,Disorder, Visual,Disorders, Visual,Hemeralopias,Impairment, Visual,Impairments, Visual,Macropsias,Metamorphopsias,Micropsias,Vision Disabilities,Vision Disorder,Visual Disorder,Visual Impairments
D014794 Visual Fields The total area or space visible in a person's peripheral vision with the eye looking straightforward. Field, Visual,Fields, Visual,Visual Field

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