Assessing visual field progression in glaucoma may be more of an art than a science—and there is no one test to give reliable information that is needed about a patient, said Chris A. Johnson, PhD, DSc, FAAO, FARVO, professor, Department of Ophthalmology, and director, Visual Field Reading Center, University of Iowa, Iowa City.
One barrier when looking at progression of visual field loss in glaucoma is there can be various types of impairment, be they systemic or ocular. This can include cataracts, corneal problems, retina disease, or optic neuropathies or systemic issues such as diabetes, inflammatory, infiltrative, or compression lesions.
Other challenges include subjective analyses and reliability of results, as well as considerable variability from one test to another, Dr. Johnson said.
Another challenge is that assessing progression is usually different when comparing multi-center trials with routine management.
Sometimes, circumstances specific to a patient can make assessment of visual field progression difficult. Dr. Johnson referred to a visual field from a patient who would seem to get worse every 6 months and then get better, but then get worse again before getting better.
“Has this person progressed or not? That’s the critical issue,” he said.