Visual Field Test

basic level

Overview
A visual field acuity test is a painless test that
determines how well a person can see. The test
maps central vision as well as peripheral (side)
vision. The test is performed by an ophthalmologist
and is used to detect areas of vision loss (blind
spots) caused by a brain tumor, stroke, glaucoma,
diabetes, hypertension, or head trauma. It can also
be used to monitor the progression of previously
known visual field loss.

How does a visual field test work?

During a visual field acuity test, also called a
perimetry test, you will respond to a series of
flashing lights while looking straight ahead.
Your responses will help the doctor determine
whether you have a visual field loss.

The area of vision loss gives clues as to where in

the visual pathway a problem has occured. Vision
begins with special receptors at the back of the eye
in the retina. The image captured by each eye is
sent to the brain by the optic nerves (Fig. 1). When
the nerves reach the optic chiasm, they cross over
each other. The nerve fibers from the inside half of
each retina cross to the other side of the brain,
while the nerve fibers from the outside half of the
retina stay on the same side of the brain. At the
end of the optic nerve, the optic radiations send the
images to the occipital lobe at the back of the brain.
The area where vision is interpreted is called the
primary visual cortex.

What does a visual field test show?

The visual field test produces a computer printout
of the light thresholds that the patient’s eyes were
able to perceive and process (Fig. 2). The darkest Figure 1. Visual field defects can vary depending where
along the visual pathway a lesion (red triangle) is located.
areas of the test indicate a complete loss of vision
in that area. The lighter the area, the more vision
the patient has in that part of the eye.

Visual field loss, also known as “visual field cut,”

can be partial or complete. For example, it can
range from a nearly complete loss of peripheral
vision to a small area of partial loss. People with
visual field loss may have trouble seeing objects out
of the corner(s) of their eyes, lose their place while
reading, startle when people or objects move
toward them, or bump into people and objects. Figure 2. Visual field test of a patient with a meningioma
shows vision loss (black areas) in half of the right eye,
called hemaniopia.

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A visual field test can also tell the ophthalmologist Following the visual field test, your eyes may be
and surgeon whether a lesion is located in front of, dilated to examine the retina, macula, and optic
on, or behind the optic chiasm. Such information is nerve. This is to ensure that there is no other cause
used to help plan the patient’s surgery and to for visual field loss, visual impairment, or other
establish a vision baseline that can be referred to ocular disease.
for comparison after brain surgery.
What are the risks?
Who performs the test? The test carries no risks.
An ophthalmologist, a doctor who specializes in
diseases and surgery of the eye, eyelids, and areas How do I get the test results?
surrounding the eyes, performs the visual field test. A neuro-ophthalmologist will promptly review your
You also may be examined by a neuro- results and communicate directly with your
ophthalmologist, a specialist who treats patients referring doctor, who will discuss the results with
with vision problems that originate in the brain. A you at a later time.
neuro-ophthalmologist can be either a neurologist
or an ophthalmologist with additional training. Eye Sources & links
problems most likely to need treatment by a neuro-
If you have further questions about this diagnostic
ophthalmologist are those that affect the optic
test, contact the doctor who ordered the test.
nerve or the nerves that control the eye muscles
and pupils.
Links
www.aao.org
How should I prepare for the test? www.geteyesmart.org
There is no special preparation for the test. Listen
closely while undergoing the test so that the results
are as accurate as possible. Glossary
bitemporal hemianopia: the two halves lost are
on the outside of each eye's peripheral vision,
What happens during the test? effectively creating a central visual tunnel.
During the test you will sit in front of a concave
hemianopia: loss of half of the visual field.
dome and stare at an object in the middle. Each
homonymous hemianopia: the two halves lost
eye is tested separately, and the eye not being
are on the corresponding area of visual field in
tested is covered with a patch. You will be asked to
both eyes, i.e., either the left or the right half of
press a button when you see small flashes of light
the visual field.
in your peripheral vision.
altitudinal hemianopia: refers to the horizontal
dividing line of visual loss, with that loss
Occasionally, a patient presses the button by
occurring either above or below the line.
accident (causing a false positive) or fails to press
quadrantanopia: is an incomplete hemianopia,
the button when a flash of light appeared (causing
referring to a quarter of the schematic “pie” of
a false negative). The reliability of the test also
visual field loss.
depends on the patient’s ability to look straight
scotoma: a blind spot occurring in any part of the
ahead and avoid looking around at the targets. A
visual field.
patient who is sleepy or confused may also have
difficulty doing the test.
updated > 11.2010
Visual field results are interpreted to establish
reviewed by > Tara Orgon Stamper, NP, Karl
artifact from disease to account for an abnormal
Golnick, MD
test. Some patients will have a completely normal
test, while others will show a visual field loss that is
in one or both eyes).

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intended to replace the medical advice of your health care provider. For more
information about our editorial policy and disclaimer, visit our Web site or write
to Tom Rosenberger, Vice President Communications. 506 Oak Street • Cincinnati, OH 45219
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© Mayfield Clinic 2010. All rights reserved.

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