Elsevier

Ophthalmology Glaucoma

Volume 5, Issue 3, May–June 2022, Pages 313-324
Ophthalmology Glaucoma

Original Article
Patients’ Views of Visual Field Testing and Priorities for Research Development and Translation into Practice

Presented at: Association for Research in Vision and Ophthalmology Annual Meeting, May 2021, San Francisco, California.
https://doi.org/10.1016/j.ogla.2021.10.003Get rights and content

Purpose

Information regarding the views of patients, on visual field testing is limited, and no information exists regarding their preferences for test developments. This study aimed to increase knowledge of patients’ experiences of visual field assessment and to explore their opinions and priorities regarding current areas of research and development.

Design

Online questionnaire with purposive sampling design.

Participants

Adults who regularly undergo visual field tests in Australia who report having glaucoma or being at glaucomatous risk.

Methods

An anonymous survey, implemented using the Qualtrics webtool, with both closed- and-open ended questions designed to explore opinions regarding visual field testing, visit attendance for perimetry, as well as priorities for developments.

Main Outcome Measures

The survey assessed 3 domains: (1) opinions regarding test duration and visit frequency, (2) subjective experience, and (3) perspectives on future developments.

Results

One hundred fifty-two complete survey responses were obtained. The median age of participants was 66 years (interquartile range [IQR], 60–72 years). Most participants (70%) had experience of undergoing more than 11 visual field tests. Participants recalled that they completed visual field tests in median of 6 minutes (IQR, 5–8 minutes) and were willing to accept additional time (median, 5 minutes; IQR, 3–6 minutes) to obtain more information. Participants were prepared to increase both the number of visual field tests per eye and the frequency of visual field tests (median, 3 visits per year; IQR, 2–4 visits per year) to gain more information about their visual status. Regarding future developments, the most preferred option was “similar test times but an increase in the level of information about my visual field,” which ranked significantly higher than all other options, including “shorter test times that maintain the currently available level of information about my visual field.”

Conclusions

Our study confirms, in a different population and health care system, previous research reporting patient perspectives on visual field assessment. We further revealed that health care consumers show a strong preference for accurate information about their vision and report being prepared to undergo longer visual field tests or more visual field tests to achieve that outcome.

Section snippets

Study Design

This study was an online questionnaire with purposive sampling focused on people with glaucoma or at risk of glaucoma who regularly undergo visual field tests in Australia. To obtain input from people from across Australia attending a variety of clinical practices, we recruited our survey participants primarily via online newsletters and social media from Glaucoma Australia,31 a support group for people with glaucoma in Australia that provides education, support, and advocacy to people with

Demographics

The median age of the included survey respondents was 66 years (range, 30–86 years; IQR, 60–72 years). Thirty-six respondents (24%) were men and 116 respondents (76%) were women. At the time of responding to the survey, 93% of participants reported having a diagnosis of glaucoma (number of years with glaucoma, 10 [range, 1–61 years; IQR, 4–20 years]) and 7% reported being at risk of glaucoma developing. Most participants (79%) regularly underwent visual field tests in a community ophthalmology

Discussion

Automated perimetry has been part of mainstream clinical practice for decades, and yet evidence directly from health care consumers regarding their experience and opinions of visual field testing is limited. Importantly, our study solicited this information, anonymously and at a distance from any specific clinical or patient environment. Previous research has explored participants, experiences of visual field assessment8,26,27; however, the novel focus of our study was to enquire directly about

Acknowledgment

The authors would like to thank Glaucoma Australia for their support in advertising and recruiting participants for this survey, and the anonymous reviewers and editorial board members for their suggestions on improving this paper.

References (45)

  • D.B. Henson et al.

    Response variability in the visual field: comparison of optic neuritis, glaucoma, ocular hypertension, and normal eyes

    Invest Ophthalmol Vis Sci

    (2000)
  • U. Schiefer et al.

    Increased detection rate of glaucomatous visual field damage with locally condensed grids: a comparison between fundus-oriented perimetry and conventional visual field examination

    Arch Ophthalmol

    (2003)
  • M. Wall et al.

    The effective dynamic ranges for glaucomatous visual field progression with standard automated perimetry and stimulus sizes III and V

    Invest Ophthalmol Vis Sci

    (2018)
  • F.G. Junoy Montolio et al.

    Persistence, spatial distribution and implications for progression detection of blind parts of the visual field in glaucoma: a clinical cohort study

    PLoS One

    (2012)
  • F.G. Junoy Montolio et al.

    Factors that influence standard automated perimetry test results in glaucoma: test reliability, technician experience, time of day, and season

    Invest Ophthalmol Vis Sci

    (2012)
  • F.C. Glen et al.

    A qualitative investigation into patients’ views on visual field testing for glaucoma monitoring

    BMJ Open

    (2014)
  • B. Foot et al.

    Surveillance of sight loss due to delay in ophthalmic treatment or review: frequency, cause and outcome

    Eye (Lond)

    (2017)
  • R. Malik et al.

    A survey of attitudes of glaucoma subspecialists in England and Wales to visual field test intervals in relation to NICE guidelines

    BMJ Open

    (2013)
  • B.C. Chauhan et al.

    Practical recommendations for measuring rates of visual field change in glaucoma

    Br J Ophthalmol

    (2008)
  • D.P. Crabb et al.

    Intervals between visual field tests when monitoring the glaucomatous patient: wait-and-see approach

    Invest Ophthalmol Vis Sci

    (2012)
  • A. Turpin et al.

    Improving spatial resolution and test times of visual field testing using ARREST

    Transl Vis Sci Technol

    (2018)
  • V. Muthusamy et al.

    Increasing the spatial resolution of visual field tests without increasing test duration: an evaluation of ARREST

    Transl Vis Sci Technol

    (2020)
  • Cited by (0)

    Supplemental material available at www.ophthalmologyglaucoma.org.

    Disclosure(s):

    All authors have completed and submitted the ICMJE disclosures form.

    The author(s) have made the following disclosure(s): A.T.: Consultant – CenterVue SpA; Financial support – Haag-Streit AG, Heidelberg Engineering GmBH

    A.M.M.: Consultant – CenterVue SpA; Financial support – Haag-Streit AG, Heidelberg Engineering GmBH

    Supported by the Melbourne Research Scholarship (V.M.); and College of Optometrists Research Fellowship (J.D.).

    HUMAN SUBJECTS: Human subjects were included in this study. The human ethics committees at the University of Melbourne approved the study. All research adhered to the tenets of the Declaration of Helsinki. All participants provided informed consent.

    No animal subjects were included in this study.

    Author Contributions:

    Conception and design: Muthusamy, Turpin, Nguyen, Denniss, McKendrick

    Analysis and interpretation: Muthusamy, Turpin, Nguyen, Denniss, McKendrick

    Data collection: Muthusamy, McKendrick

    Obtained funding: N/A; Study was performed as part of regular employment duties at the University of Melbourne, Australia. No additional funding was provided.

    Overall responsibility: Muthusamy, Turpin, Nguyen, Denniss, McKendrick

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