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Christopher D. Riemann, MD; Susan Hanson, COT; Jill A. Foster, MD

Arch Ophthalmol. 2000;118:65-69.

Objective  To compare examination time and visual field loss for ptosis fields obtained with manual kinetic (Goldmann) perimetry and automated static (Humphrey) perimetry.

Methods  Both eyes of 12 patients with bilateral aponeurogenic ptosis were prospectively examined using Goldmann and Humphrey (ptosis protocol) perimetry with the eyelids ptotic and taped into a normal position.

Results  Bilateral examination time for Goldmann fields was 10 ± 2 minutes and for Humphrey fields was 50 ± 10 minutes (P<.001, n = 12). Superior fields at the 12:00 meridian were 46° ± 6° taped, and 28° ± 12° untaped for Goldmann perimetry (P<.001), and 38° ± 8° taped, and 24° ± 12° untaped for Humphrey perimetry P<.001). Goldmann field loss was 18° ± 9° (taped minus untaped). Humphrey field loss was 14° ± 13° (P<.04, n = 24). Mean Goldmann radial fields were 56° ± 6 ° taped and 39° ± 13° untaped (P<.001). Goldmann superior hemifield areas were 5167 ± 964 degrees² taped and 2830 ± 1466 degrees² untaped (P<.001). Humphrey mean vertical superior hemifield was 37° ± 9° taped and 21° ± 11° untaped (P<.001). Mean sensitivity of Humphrey fields was 15 ± 3 dB taped and 9 ± 5 dB untaped (P<.001). Mean vertical center of gravity was 23° ± 3° taped and 16° ± 5° untaped (P <.001).

Conclusion  Goldmann manual kinetic and Humphrey automated static visual field testing are both effective in documenting ptosis associated visual field loss. Humphrey automated ptosis fields, as performed in this study, require longer examination times than Goldmann manual fields and may be a less sensitive indicator of field loss.

From The Cleveland Clinic Foundation, Division of Ophthalmology, Cleveland, Ohio.

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