AAOpt 2022: Visual fields in 2022

Jack Phu, OD, MPH, PhD, a researcher as UNSW Sydney, shares key takeaways from his discussion, "Visual fields in 2022: still relevant to your clinical practice?" which he presented during the 2022 American Academy of Optometry (AAOpt) meeting in San Diego.

Editor's note: This transcript has been edited for clarity.

Hi, everyone, I'm Jack, and it's a great pleasure to get to be here again at the Academy after 3 long years of COVID. It's been an amazing meeting so far, and I'm so happy to be here in person again, to be able to share and meet up with colleagues again.

This year, I'm going to be presenting on a few topics. And this one that I wanted to talk about is on visual fields. And in 2022, are we still using visual fields in our clinical practice?

You might think that we'll be doing OCTs now because it's so noninvasive, it's quick, it's easy to interpret if patients feel very comfortable doing it. But what about visual fields? It's something that it's a little bit more arduous, we have to sit down, instruct the patient, and we have to ask them to respond to things that are quite challenging. Our technicians often don't like sitting in a dark room watching the patients, as well.

But visual fields still give us some very critical information about the patient's subjective response to the world around them. How do they see; how do they perceive the world? And we have to really understand that to understand their visual condition.

So in this talk on visual fields in 2022, I wanted to highlight how we can still use visual fields to understand the patient's ocular status. So understand things about their retinal disease, their glaucoma, and diseases of the visual pathway beyond the retina. So your motor vehicle accidents and your stroke patients, that's where visual fields will be absolutely critical in understanding their residual visual function, and things like visual rehabilitation, as well.

I wanted to give a refresher on the different visual field testing techniques that we still have at our disposal, not just relying on our 24-2 test the grid, but also thinking about 10-2 testing and kinetic perimetry, because they remain absolutely critical for understanding and having a holistic view of our patients' visual functions.

I wanted to introduce, as well, some newer concepts about front-loading, which our lab has really pushed along in recent years, where we do 2 visual field tests per clinical visit in order to get maximum reliable and repeatable information on our patients to better understand their visual status. I really wanted to talk a lot about front-loading visual fields and overcoming barriers of data loss when we have an unreliable data point. And we say we can just repeat the test on the same day, get that data point and be absolutely conclusive about the visual field test results. And I wanted to show some results from our research program, showing that frontloaded visual fields are able to detect visual field defects and progression years sooner than our current clinical standard.

So if you weren't able to join us in our session talking about visual fields in 2022, the notes will be uploaded. And if you have any questions, please feel free to email me at my institutional email (jack.phu@unsw.edu.au) and I'm happy to engage in further discussions with you but I hope you had a wonderful meeting this year.