Oculokinetic perimetry in the detection of glaucoma
Glaucoma tends to be detected late in the disease, when severe visual-field loss has already occurred. A simple and inexpensive visual-field test has been developed to allow earlier detection of glaucoma when other methods are impractical. This test uses a hand-held multifixation campimeter, which is a white tangent screen with a central black test stimulus and a series of numbered fixation targets. As the patient reads the numbers, eye movements shift the printed stimulus into known locations in the visual field. A test grid that assays the central 15° field with a 1.5/40 black stimulus can detect the large majority of dense glaucomatous defects, but the examination can be adjusted according to the examiner's skills and the patient's visual acuity, age, and degree of cooperation. The dark stimulus is more constant than light stimuli under variable lighting conditions, and preliminary work suggests that it may detect defects missed by conventional light stimuli. Further studies under normal community conditions are required to evaluate this test for the detection of glaucoma and to prepare guidelines for its use.