Confrontation visual field techniques in the detection of anterior visual pathway lesions

Abstract

The accuracy of a variety of finger and color confrontation tests in identifying chiasmal and optic nerve visual field defects was assessed in patients whose field defects had been established beforehand by a conventional achromatic kinetic technique on the Goldmann perimeter. Kinetic and static finger confrontation methods identified an average of 42% of the 28 chiasmal hemianopic defects. False negatives included eyes with hemianopias complete to the largest (V4e) Goldmann isopter. False positives (average, 15%) occurred in eyes containing nerve fiber bundle defects with borders that fell near the vertical fixational meridian. Kinetic and static color confrontation techniques were 78.6% sensitive to hemianopias. Accuracy did not differ significantly whether the red target was presented kinetically or statically against the tangent screen, projected on the Autoplot screen, or held in the examiner's hand without attention to background. False positives (average, 23%) were slightly greater than with finger confrontation methods and occurred not only in eyes with nerve fiber bundle defects but also in eyes with no defects in reference visual fields. Finger confrontation identified 11% or fewer of optic nerve field defects, while some color techniques detected as many as 31 1/3%. There were no false positives.

Neglect and Anosognosia After First-Ever Stroke: Incidence and Relationship to Disability

“…In our study, it is possible that additional neglect patients would have been revealed had we used a still broader test battery, covering also for example motor neglect and neglect of far space. Some authors have shown that traditional tests, such as paper-and-pen tests, are insensitive for determining the presence of neglect (23,24), and that more demanding assessment methods have to be used to reveal subtle signs of neglect. It has also been shown in some subjects that carrying out an attention-demanding task temporarily aggravates neglect symptoms (25).…”

Visual parameters in patients with pituitary adenoma before and after transsphenoidal surgery

“…Thus, a total of 126 eyes were evaluated preoperatively and at some time postoperatively. Within one week after surgery, 122 eyes of 6 1 patients (97%) were examined. Subsequent examinations were performed on 106 eyes of 53 patients (84?70).…”

Differentiating retinal from optic nerve syndromes

“…However, it does only help in gross field defects such as central scotomas, altitudinal defects, bitemporal hemianopsias, or homonymous hemianopsias [6]. Confrontation visual field may miss up to two-thirds of optic nerve-related defects [7], and is likely even less sensitive for maculopathy.…”