Researchers recently discovered visual field results can be negatively affected by certain ocular surface conditions in patients with glaucoma, calling for careful attention when testing these patients.

Using the Humphrey 24–2 visual field (Zeiss) in conjunction with tear break-up time, Schirmer’s testing, tear meniscus volume (TMV) and superficial punctate keratopathy (SPK) assessment, investigators in Japan found SPK was positively associated with a high frequency of eye movements between 3° and 5°, and even 6° and above. Furthermore, high TMV was associated with increased rate of tracking failure frequency per stimulus.

Findings not associated with gaze tracking (GT) or ocular surface measurements included fixation losses, false-positives and false-negatives.

“Careful attention should be paid when interpreting GT parameters in patients with SPK or a large TMV,” the researchers concluded.

Arai T, Murata H, Matsuura M, et al. The association between ocular surface measurements with visual field reliability indices and gaze tracking results in preperimetric glaucoma. Br J Ophthalmol. 2018;102(4):525-30.