ODs should consider performing both monocular and binocular visual field testing to best determine a glaucoma patient’s ability to perform everyday tasks like grasping small objects and face recognition, according to a new study in the Journal of Glaucoma.

French researchers included 32 patients with chronic glaucoma at the Quinze-Vingts National Ophthalmology Hospital in this pilot study, which used simulated daily activities as a measurement tool.

The investigators conducted a clinical evaluation of visual function including best-corrected visual acuity, contrast sensitivity, and monocular and binocular visual field tests. 

Researchers used standardized artificial platforms to evaluate four different tasks: mobility, reaching and grasping, localization of people and face orientation recognition. 

For mobility, patients walked along four different courses, including a route in an office with obstacles such as chairs, desks, tables, low contrasted grey boxes on the floor and mannequins. Researchers measured how long it took the patients to walk the route from start to finish and recorded any incidents, such as bumps, stumbling and stops. For reaching and grasping, subjects sat at a simulated kitchen counter where small, medium and large objects were placed in front of them. To measure face orientation recognition, subjects opened their eyes at the sound of a beep and then had to identify how many simulated individuals were looking in their direction. Researchers evaluated localization of people through another simulated test that had participants open their eyes and then identify a model wearing a black scarf as quickly as possible.

The study correlated patient performance in the different tasks with visual field evaluation including integrated binocular visual field (IVF), VF mean deviation (MD) of the better and the worse eye, Esterman binocular VF, best corrected visual acuity and contrast sensitivity.

The study noted the IVF score was significantly correlated with time for localization of people and face orientation recognition. Additionally, they found the IVF score was significantly correlated with movement onset for reaching and grasping small objects. Investigators found the mean deviation of the better eye appeared significantly correlated with face orientation recognition time and localization of people time. The Esterman score appeared significantly correlated with mobility time, localization of people and face orientation recognition times, and movement onset for reaching and grasping large objects.

“The IVF score and the MD of the better eye appeared to better evaluate reaching and grasping, face orientation recognition, and localization of people simulated tasks, whereas for the mobility task, the Esterman VF seemed more useful,” the researchers wrote in their study. “The precise evaluation of the glaucoma patient's ability to perform everyday life tasks is complex and may require both monocular and binocular visual field tests.”