Development of a Pediatric Visual Field Test

Abstract

PurposeWe describe a pediatric visual field (VF) test based on a computer game where software and hardware combine to provide an enjoyable test experience.MethodsThe test software consists of a platform-based computer game presented to the central VF. A storyline was created around the game as was a structure surrounding the computer monitor to enhance patients' experience. The patient is asked to help the central character collect magic coins (stimuli). To collect these coins a series of obstacles need to be overcome. The test was presented on a Sony PVM-2541A monitor calibrated from a central midpoint with a Minolta CS-100 photometer placed at 50 cm. Measurements were performed at 15 locations on the screen and the contrast calculated. Retinal sensitivity was determined by modulating stimulus in size. To test the feasibility of the novel approach 20 patients (4–16 years old) with no history of VF defects were recruited.ResultsFor the 14 subjects completing the study, 31 ± 15 data points were collected on 1 eye of each patient. Mean background luminance and stimulus contrast were 9.9 ± 0.3 cd/m2 and 27.9 ± 0.1 dB, respectively. Sensitivity values obtained were similar to an adult population but variability was considerably higher – 8.3 ± 9.0 dB.ConclusionsPreliminary data show the feasibility of a game-based VF test for pediatric use. Although the test was well accepted by the target population, test variability remained very high.Translational RelevanceTraditional VF tests are not well tolerated by children. This study describes a child-friendly approach to test visual fields in the targeted population.

Diagnostic Performance and Repeatability of a Novel Game-Based Visual Field Test for Children

“…We were able to recruit 21 children with established pathology where visual field changes might be expected and all children completed the test satisfactorily. Median age was 12 (range, [4][5][6][7][8][9][10][11][12][13][14][15][16]. Thirteen children had congenital glaucoma, seven had secondary glaucoma, and one had neurological damage to a temporal lobe.…”

“…Further details including the development of the test hardware and software are given in previous publications. 8,9,12 We recorded details of consenting children and pertinent game data including visual field outcomes and reliability indices. One eye of each child was used for the study, determined by subject preference.…”

Pediatric Perimeter—A Novel Device to Measure Visual Fields in Infants and Patients with Special Needs

“…Such a perimetric procedure of permitting eye movements is increasingly explored both for adults and children. 2 , 28 However, the testing conditions for those equipments require the patient to be seated. We found the supine position in dark room testing to be encouraging for our patients with cognitive impairment.…”

“…Even testing young children (age, ≥4 years) still remains a challenge. 1 , 2 Infants and children with neurological impairments (e.g., neonatal encephalopathies) are known to have visual field defects. 3 , 4 It has been reported that in otherwise healthy individuals, visual field defects arising during infancy gets detected only in adulthood.…”

Exploring the dualism of vision – visual function and functional vision

“…The Model of Health and Health Deficits has been applied by authors contextually to vision impairment (Berger and Porell, 2008;Crews et al, 2012); and as a framework for the outcomes of certain interventions (Neves et al, 2005).…”