Pupillary anomaly masquerading as a glaucomatous visual field defect: a case report

BACKGROUND: Patients are often referred to ophthalmologists with focal visual field defects on routine testing, possibly related to a potential diagnosis of glaucoma. However, examination of the individual patient's ocular characteristics as well as facial characteristics may often reveal a cause of the visual field defect. CASE PRESENTATION: We describe a patient who was found to have a superior visual field defect on routine testing by the optician. Repeat perimetry with pharmacological dilatation of the pupil revealed that the cause of the field defect was related to an eccentric inferiorly displaced pupil, secondary to trauma some years previously. DISCUSSION: Individual patient characteristics, including both ocular, as well as facial, need to be considered, when interpreting any visual field defect

Alterations in the shape of the automated perimetric profile arising from cataract

The attenuation of the perimetric response arising from cataract was investigated and related to the degree of cataract quantified by glare sensitivity. Visual fields were measured with the Octopus and Dicon automated perimeters out to an eccentricity of 30 degrees. Nuclear and non-nuclear cataracts differed in their effect on the perimetric profile. Non-nuclear cataracts exhibited the same qualitative characteristics as a model developed in previous studies, whereby the overall pattern of perimetric attenuation was dependent upon target configuration. For these subjects, perimetric sensitivity was depressed to a greater extent at an eccentricity of 30 degrees compared with fixation when measured with the large projected stimuli, whereas the reverse was true when sensitivity was measured with the small LED stimuli. Conversely, nuclear cataracts depressed perimetric sensitivity to a greater extent at the fovea compared with more peripheral regions for both the large projected and small LED stimuli