Purpose To evaluate the learning effect of frequency doubling technology (FDT) perimetry using the Humphrey Matrix perimeter in healthy subjects with no perimetric experience. Methods One eye of 28 healthy adults who had no history of visual field testing underwent three Matrix tests using 24-2 programme with full-threshold strategy. The results of the first session were compared with those of the second, and the third sessions. Learning effect was defined as an improvement at results for duration, perimetric indices, and the number of points with a Po5 and o1% in the total and pattern deviation maps. Anderson's criteria were applied to define abnormal examinations. Results The mean in the mean deviation global index was À7.40 ± 1.49 dB in the first session, À4.64±0.97 dB in the second session, and À3.29±0.93 dB in the third session. Pattern standard deviations were decreased as the tests were repeated (Po0.01). Test duration, fixation losses, false negative, and the number of points with a Po5 and o1% in the total and pattern deviation maps rate were also changed significantly (Po0.05). Among the criteria suggested by Anderson, the Glaucoma Hemifield Test performed better in all session tests. The false-positive rates ranged from 50% (95% confidence intervals [CI] 30.6-69.4%) to 64% (95% CI 44.1-81.4%) for the first session, 29% (95% CI 13.2-48.7%) to 54% (95% CI 33.9-72.5%) for the second session, and from 18% (95% CI 6.1-36.9%) to 32% (95% CI 15.9-52.4%) for the third session. ConclusionsThe results of this study show that the learning effect for Humphrey Matrix FDT perimetry must be considered in normal individuals with no perimetric experience.

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Purpose: To evaluate the profile of all the visits to the ophthalmic emergency service at a tertiary hospital in the city of Sobral, Ceará, northeast of Brazil. Methods: A survey was carried out of all patients attended at ophthalmology emergency service of the department of ophthalmology of Santa Casa of Sobral, during the period between may and october 2008. Data on patient's age, sex, level of education, residential address, health insurance status, average distance to our service, time between the initial symptoms and first visit to the hospital, site of medical evaluation indication, diagnosis, and veracity of emergency indication. All these data were collected during interview and ophthalmological examination. Results: A total number of 1,024 patients were analyzed in the study. Mean and standard deviation to age was 31.5 ± 17.1 years (ranging from zero to 81). Sixty-five per cent of the patients were male and 35% female. Twenty-one per cent of the patients lived at least 50 kilometers away from the Santa Casa of Sobral. Ocular traumas (40.9%) of any nature were the most frequent occurrence, followed by infections (29%). About 45 % of cases were not considered as a true emergency and could be managed in primary or secondary health care centers. About the initial symptoms and first visit to the hospital, only 24% of the patients went to the ophthalmology emergency room on the same day in which their symptoms started. Conclusion: A great number of patients attended or treated at the ophthalmology emergency service of Santa Casa of Sobral presented with common ocular disorders of simple resolution. Therefore there is a failure in the primary and secondary health care to manage it. Certainly a considerable proportion of these patients had conditions which could have been diagnosed and treated in an ophthalmic outpatient clinic or by general practitioners.

Purpose. To evaluate the learning effect of frequency doubling technology (FDT) perimetry using the Humphrey Matrix perimeter in patients with open-angle glaucoma with no perimetric experience. Methods. One eye each of 30 glaucoma patients who had no history of visual field testing underwent 3 Matrix tests using 24–2 program with full-threshold strategy. The parameters investigated to detect learning effect were test duration, reliability indexes, mean deviation (MD), pattern standard deviation (PSD), and the number of points with a p of <5% and <1% in the total and pattern deviation maps. Results. MD showed a larger defect at the first test (-13.64 ± 1.63 dB) than at the second (-12.68 ± 1.45 dB) and third (-11.69 ± 1.48 dB) tests (p<0.05). A statistically significant reduction (p<0.05) in the number of points with a p <5% and <1% in the total deviation map was observed when repeating the examination. The values of test duration, PSD, fixation losses, false-positive rate, false-negative rate, and number of points with a p <5% and <1% in the pattern deviation map were not changed significantly (p>0.05). Conclusions. Humphrey Matrix FDT perimetry showed a statistically significant learning effect on MD and the number of significantly depressed points of the total deviation map in glaucoma patients with no perimetric experience. It is probably necessary to obtain at least 3 repetitions to rule out the presence of a learning effect in such patients before providing useful results.