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AutoPeri(NM)
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Interpretation is not child’s play
Automated perimeters still need interpretation
© Thomas R
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Before interpretation …
… a few principles
© Thomas R
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Rely on threshold tests
•First real evidence of glaucoma
•Detect scotoma
•Detect depression of the ‘hill’ of vision
•May predict visual loss
© Thomas R
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Screening tests
•Screening
•Fishing
•Fatigue
© Thomas R
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Interpreting decibel values is just half the challenge …
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• False positives |
• Strategy |
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• False negatives |
• Experience |
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Fixation |
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Technicians |
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Fluctuation |
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Artefacts |
© Thomas R
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© Thomas R
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Optimising patient performance
•Choose the most appropriate investigation
–Test pattern and strategy
•Ensure the patient is comfortably positioned
–Support feet, back and arms
–Adjust chin rest
–Cover the other eye fully
•Provide careful instructions prior to the test
•Support the patient during the test
•Give feedback on test performance
SEAGIG. Asia Pacific Glaucoma Guidelines©.2003Thomas–2004R .
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A word about the grey scale
•Never use the grey scale alone for interpretation
•It is useful to educate the patient and to identify false-positive and false-negative errors
© Thomas R
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‘White’ scotomas associated with false positives
© Thomas R
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© Thomas R