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Nicholas D. Smith, David P. Crabb, David F. Garway-Heath; How Does Glaucoma Look? A Study Of Patient Perception Of Visual Field Defects. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4414.
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To explore patient perception of glaucomatous visual field (VF) defects, and to test the hypothesis that patients do not recognise their impairment as a ‘tunnel effect’ or ‘black patches’ in their field of view.
Twenty-nine patients (age range: 52 to 82 years) with a range of glaucomatous VF defects in both eyes (visual acuity better than 6/9) from a recruitment target of 50 took part in a recorded interview. Participants were asked if they were aware of their VF defect, and if so, were encouraged to describe it in their own words. Participants were also shown six images (figure 1; A-F) in random order on a computer monitor and asked to select (forced choice) the image that most closely represented their perception of their VF defect.
Thirteen patients (45%; 95% confidence interval [CI]: 26-64%) claimed to be unaware of their visual field defect (Mean [range] MD: -5.2 [1.4 to -17.1]dB in the better eye). Fifteen patients (52%; 95% CI: 33-70%) chose image D (blurred parts/patches) as the image that best represented their perception of their impairment (Mean [range] MD: -7.5 [-2.0 to -19.4]dB in the better eye). One patient (3%; 95% CI: 0-18%) chose image E (missing parts/patches). No patients chose the images with tunnel effects or black patches (images A, B and C). Interim analysis of the transcripts from the recorded interviews indicated a high frequency of descriptors associated with ‘blur’.
Patients with glaucoma do not perceive their visual field defect as a ‘tunnel’ effect or as ‘black patches’ masking their field of view. These findings are important in the context of depicting the effects of the disease and raising awareness for detection and case finding.
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