SIMULATING BINOCULAR VISUAL-FIELD STATUS IN GLAUCOMA

Aims-To simulate the central binocular visual field using results from merged left and right monocular Humphrey fields. To assess the agreem ent between the simulation and the binocular Humphrey Esterman visual field test (EVFT). Method-59 consecutive patients with bilateral glauc oma each recorded Humphrey 24-2 fields for both eyes and binocular EVF T on the same visit. EVFT results were used to identify patients exhib iting at least one defect (<10 dB) within the central 20 degrees of th e binocular field. This criterion is relevant to a patient's legal fit ness to drive in the UK. Individual sensitivity values from monocular fields are merged to generate a simulated central binocular field. Res ults are displayed as a grey scale and as symbols representing defects at the <10 dB level. Agreement between patients failing the criterion using the simulation and the EVFT was evaluated. Results-Substantial agreement was observed between the methods in classifying patients wit h at least one defect (<10 dB) within the central binocular field (kap pa 0.81; SE 0.09). Patients failing this criterion using the EVFT resu lts were identified by the binocular simulation with high levels of se nsitivity (100%) and specificity (86%). Conclusions-Excellent agreemen t exists between the simulated binocular results and EVFT in classifyi ng glaucomatous patients with central binocular defects. A rapid estim ate of a patient's central binocular field and visual functional capac ity can be ascertained without extra perimetric examination.