Baghdad University
College of Medicine
Ophthalmology Department
Objectives
At the end of this session the students will
be able to:
Define visual field, scotoma and perimetry
Describe static and kinetic perimetry with
examples
Describe types of scotoma with examples
Identify the visual field drawing
Describe common visual field defects and
their causes
Definitions
An island of vision in
Visual Field
a sea of darkness
Scotoma
Scotoma is an area of partial or complete loss of vision surrounded
by a normal visual field.
Visual Field
Central visual field (macular) central
30°.
Peripheral visual field (extramacular)
out of central 30°.
VISUAL PATHWAY
Confrontation test
Confrontation test
PERIMETRY
Kinetic perimetry
Static perimetry
Kinetic perimeter
Simple confrontation
Goldmann ‘s perimeter
Goldmann
Static perimeter
Automated perimeter
Visual field monitoring in glaucoma
Respect the horizontal
Nervous disease respect the vertical
humphrey
Gold mann
Assessment of peripheral visual field by:
1- Confrontation visual field.
2- Goldmann visual field.
3- Automated and computer-assisted
perimeters.
Assessment of central visual field by:
1- Goldmann visual field.
2- Automated perimeter.
3- Tangent screens.
4- Amsler grid.
Goldmann
left eye
humphrey
OS (oculus sinister) means the
left eye and OD (oculus dextrus)
means the right eye
Amsler Grid
Scotoma
Complete loss of
Absolute vision
Relative Partial loss of
vision
Positive Appears as a dark spot in the visual field
Negative The patient is unaware of its
prescence
absolute and negative scotoma: e.g. blind spot and it is also a physiological scotoma
Relative scotoma: usually many types of scotoma start as relative
Positive e.g. optic neuritis
Types of VF defects
Central
Central scotoma
Centrocaecal Central to blind spot
Paracentral
Arcuate scotoma
Altitudinal field defect
Enlargement of blind spot
Types of VF defect
Peripheral
Bitemporal hemianopia
After chiasmal Homonymous hemianopia
Binasal hemianopia
Constriction of the peripheral field
(tunneled vision)
Optic nerve lesion left
Some fiber are cross to
oppisiste site so cause
scotoma
Temporal
Right
optic
radiation
Pariatal optic
radiation Left
Cerebral
cortex lesion
Anterior ischemic optic neuropathy
retinal venous occlusions
retinitis pigmentosa
Optokinetic reflex