Journal of Current Glaucoma Practice

Register      Login

VOLUME 13 , ISSUE 3 ( September-December, 2019 ) > List of Articles


Novel Means of Clinical Visual Function Testing among Glaucoma Patients, Including Virtual Reality

Simon E Skalicky, George YX Kong

Keywords : Glaucoma, Perimetry, Tablet, Virtual reality, Visual function

Citation Information : Skalicky SE, Kong GY. Novel Means of Clinical Visual Function Testing among Glaucoma Patients, Including Virtual Reality. J Curr Glaucoma Pract 2019; 13 (3):83-87.

DOI: 10.5005/jp-journals-10078-1265

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Computed perimetry remains the gold standard of visual field measurement among glaucoma patients. However, several emerging technologies, made possible by advances in computer programming, smartphone, tablet, or virtual reality, allow alternative means of visual function assessment. These new visual tests may one day have a useful complementary role in visual field testing and to bridge the gap between perimetry and daily experience. Many of these emerging technologies have distinct practical advantages over Ganzfield bowl-based computed perimetry. This paper outlines a discussion of some of these emerging techniques in visual function assessment in glaucoma.

  1. Flaxman SR, Bourne RRA, Resnikoff S, et al. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob Health 2017;5(12):e1221–e1234. DOI: 10.1016/S2214-109X(17)30393-5.
  2. Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 2014;121(11):2081–2090. DOI: 10.1016/j.ophtha.2014.05.013.
  3. Varma R, Lee PP, Goldberg I, et al. An assessment of the health and economic burdens of glaucoma. Am J Ophthalmol 2011;152(4): 515–522. DOI: 10.1016/j.ajo.2011.06.004.
  4. Lorenzana L, Lankaranian D, Dugar J, et al. A new method of assessing ability to perform activities of daily living: design, methods and baseline data. Ophthalmic Epidemiol 2009;16(2):107–114. DOI: 10.1080/09286580902738142.
  5. Ramulu P, Maul E, Hochberg C, et al. Real-world assessment of physical activity in glaucoma using an accelerometer. Ophthalmology 2012;119(6):1159–1166. DOI: 10.1016/j.ophtha.2012.01.013.
  6. Goldberg I, Clement CI, Chiang TH, et al. Assessing quality of life in patients with glaucoma using the glaucoma quality of life-15 (GQL-15) questionnaire. J Glaucoma 2009;18(1):6–12. DOI: 10.1097/IJG.0b013e3181752c83.
  7. Haymes SA, Leblanc RP, Nicolela MT, et al. Risk of falls and motor vehicle collisions in glaucoma. Invest Ophthalmol Vis Sci 2007;48(3):1149–1155. DOI: 10.1167/iovs.06-0886.
  8. Burton R, Crabb DP, Smith ND, et al. Glaucoma and reading: exploring the effects of contrast lowering of text. Optom Vis Sci 2012;89(9): 1282–1287. DOI: 10.1097/OPX.0b013e3182686165.
  9. Chan EW, Chiang PP, Liao J, et al. Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning. Ophthalmology 2015;122(3):494–501. DOI: 10.1016/j.ophtha.2014.09.030.
  10. McKean-Cowdin R, Wang Y, Wu J, et al. Impact of visual field loss on health-related quality of life in glaucoma: the los Angeles Latino eye study. Ophthalmology 2008;115(6):941–948. DOI: 10.1016/j.ophtha.2007.08.037.
  11. Medeiros FA, Gracitelli CP, Boer ER, et al. Longitudinal changes in quality of life and rates of progressive visual field loss in glaucoma patients. Ophthalmology 2015;122(2):293–301. DOI: 10.1016/j.ophtha.2014.08.014.
  12. Burton R, Smith ND, Crabb DP. Eye movements and reading in glaucoma: observations on patients with advanced visual field loss. Graefes Arch Clin Exp Ophthalmol 2014;252(10):1621–1630. DOI: 10.1007/s00417-014-2752-x.
  13. Skalicky S, Goldberg I. Depression and quality of life in patients with glaucoma: a cross-sectional analysis using the geriatric depression scale-15, assessment of function related to vision, and the glaucoma quality of life-15. J Glaucoma 2008;17(7):546–551. DOI: 10.1097/IJG.0b013e318163bdd1.
  14. Mabuchi F, Yoshimura K, Kashiwagi K, et al. High prevalence of anxiety and depression in patients with primary open-angle glaucoma. J Glaucoma 2008;17(7):552–557. DOI: 10.1097/IJG.0b013e31816299d4.
  15. Crabb DP, Smith ND, Rauscher FG, et al. Exploring eye movements in patients with glaucoma when viewing a driving scene. PLoS One 2010;5(3):e9710. DOI: 10.1371/journal.pone.0009710.
  16. Freeman EE, Munoz B, Rubin G, et al. Visual field loss increases the risk of falls in older adults: the Salisbury eye evaluation. Invest Ophthalmol Vis Sci 2007;48(10):4445–4450. DOI: 10.1167/iovs.07-0326.
  17. Friedman DS, Freeman E, Munoz B, et al. Glaucoma and mobility performance: the Salisbury eye Evaluation Project. Ophthalmology 2007;114(12):2232–2237. DOI: 10.1016/j.ophtha.2007.02.001.
  18. Glen FC, Crabb DP, Smith ND, et al. Do patients with glaucoma have difficulty recognizing faces? Invest Ophthalmol Vis Sci 2012;53(7):3629–3637. DOI: 10.1167/iovs.11-8538.
  19. Ramulu P. Glaucoma and disability: which tasks are affected, and at what stage of disease? Curr Opin Ophthalmol 2009;20(2):92–98. DOI: 10.1097/ICU.0b013e32832401a9.
  20. Ramulu PY, Swenor BK, Jefferys JL, et al. Difficulty with out-loud and silent reading in glaucoma. Invest Ophthalmol Vis Sci 2013;54(1): 666–672. DOI: 10.1167/iovs.12-10618.
  21. Ramulu PY, van Landingham SW, Massof RW, et al. Fear of falling and visual field loss from glaucoma. Ophthalmology 2012;119(7): 1352–1358. DOI: 10.1016/j.ophtha.2012.01.037.
  22. Ramulu PY, West SK, Munoz B, et al. Glaucoma and reading speed: the Salisbury eye evaluation project. Arch Ophthalmol 2009;127(1):82–87. DOI: 10.1001/archophthalmol.2008.523.
  23. Altangerel U, Spaeth GL, Steinmann WC. Assessment of function related to vision (AFREV). Ophthalmic Epidemiol 2006;13(1):67–80. DOI: 10.1080/09286580500428500.
  24. Richman J, Lorenzana LL, Lankaranian D, et al. Importance of visual acuity and contrast sensitivity in patients with glaucoma. Arch Ophthalmol 2010;128(12):1576–1582. DOI: 10.1001/archophthalmol.2010.275.
  25. Wei H, Sawchyn AK, Myers JS, et al. A clinical method to assess the effect of visual loss on the ability to perform activities of daily living. Br J Ophthalmol 2012;96(5):735–741. DOI: 10.1136/bjophthalmol-2011-300093.
  26. Skalicky SE, McAlinden C, Khatib T, et al. Activity limitation in glaucoma: objective assessment by the Cambridge glaucoma visual function test. Invest Ophthalmol Vis Sci 2016;57(14):6158–6166. DOI: 10.1167/iovs.16-19458.
  27. Goh RLZ, Kong YXG, McAlinden C, et al. Objective assessment of activity limitation in glaucoma with smartphone virtual reality goggles: a pilot study. Transl Vis Sci Technol 2018;7(1):10. DOI: 10.1167/tvst.7.1.10.
  28. Vingrys AJ, Healey JK, Liew S, et al. Validation of a tablet as a tangent perimeter. Transl Vis Sci Technol 2016;5(4):3. DOI: 10.1167/tvst. 5.4.3.
  29. Kong YX, He M, Crowston JG, et al. A comparison of perimetric results from a tablet perimeter and humphrey field analyzer in glaucoma patients. Transl Vis Sci Technol 2016;5(6):2. DOI: 10.1167/tvst. 5.6.2.
  30. Prea SM, Kong YXG, Mehta A, et al. Six-month longitudinal comparison of a portable tablet perimeter with the Humphrey field analyzer. Am J Ophthalmol 2018;190:9–16. DOI: 10.1016/j.ajo.2018.03.009.
  31. Schulz AM, Graham EC, You Y, et al. Performance of iPad-based threshold perimetry in glaucoma and controls. Clin Exp Ophthalmol 2018;46(4):346–355. DOI: 10.1111/ceo.13082.
  32. Tsapakis S, Papaconstantinou D, Diagourtas A, et al. Visual field examination method using virtual reality glasses compared with the Humphrey perimeter. Clin Ophthalmol 2017;11:1431–1443. DOI: 10.2147/OPTH.S131160.
  33. Jones PR, Smith ND, Bi W, et al. Portable perimetry using eye-tracking on a tablet computer-a feasibility assessment. Transl Vis Sci Technol 2019;8(1):17. DOI: 10.1167/tvst.8.1.17.
  34. Nakanishi M, Wang YT, Jung TP, et al. Detecting glaucoma with a portable brain-computer interface for objective assessment of visual function loss. JAMA Ophthalmol 2017;135(6):550–557. DOI: 10.1001/jamaophthalmol.2017.0738.
  35. McKendrick AM, Zeman A, Liu P, et al. Robot assistants for perimetry: a study of patient experience and performance. Transl Vis Sci Technol 2019;8(3):59. DOI: 10.1167/tvst.8.3.59.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.