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Ophthalmology: Glaucoma and Visual Field Assessment
Paper instructions:
College Ophthalmic Assistant Home Study program. Need a paper on topic above. Due July 31. Would like it sooner. Paper Instruction sheet states: The purpose of
this paper is to examine in depth,an area of particular interest.  There are several ways of approaching this study. The student may research a topic with the use of
textbooks and relevant articles or through interviews with physicians, nurses, orthoptists, etc. and apply the researched material to an area within his/her own
experience OR I can do a paper which is a review of the written material on a subject either by presenting a summary of various sources read, or comparing and
contrasting the viewpoints expressed in different sources. Need a title-page, bibliography, footnotes, table of contents, diagrams, illustrations and/or graphs. Would
like to have a draft copy as soon as possible.
The importance of Visual Field Testing when diagnosing Glaucoma
This paper will investigate how visual field testing can help with detecting and diagnosing Glaucoma.  First it’s important to understand what Glaucoma is, what a
Visual Field Test is, and what information the Visual Field Test collects for the eye care professional.  Then I will share my glaucoma-screening tests with you and
tie things together.
Glaucoma is a group of eye diseases which cause irreparable damage to the optic nerve and eye function, with vision loss starting at the periphery.  Glaucoma is like a
vision-thief.  Symptoms are leisurely, unproblematic and go relatively undetected.  Nearly half of the population with glaucoma are symptom-free and have no pain
associated with the disease, making screening for glaucoma extremely important.
There are several different forms of glaucoma: primary open-angle, primary angle-closure, secondary, and congenital.   There are several risk factors to developing
glaucoma of which include intraocular pressures greater than 20mmHg, age, heredity, ethnicity (especially in African Americans and Hispanic heritage), medical
conditions (such as diabetes, long-term steroid use, and tumors), and eye trauma. According to the World Health Organization, Glaucoma is the second leading cause of
blindness globally, just behind cataracts, the difference being that much of the vision loss from cataracts is reversible with surgery and vision loss from glaucoma is
permanent.  This disease silently and unnoticeably causes visual field defects, leading to tunnel vision, and eventually blindness; however, if early screening is
done, Glaucoma can be successfully managed to avoid vision loss and blindness.
A visual field test (also known as Perimetry) is a screening assessment that essentially draws a map of a person’s entire visual area from the periphery to central
field of vision.  Automated perimetry can help to determine whether or not a person may have visual field defects.
“Automated perimetry plays an important role in both the diagnosis and the follow-up care of patients with Glaucoma.”
Marrelli, Danica J. “Glaucoma: Visual Field Interpretation for the Busy Practitioner.” OptometryTimes. Advanstar Communications Inc., 2009.
“The assessment of the visual field…is the mainstay of deciding whether glaucoma therapy has been adequate for an individual patient, because the entire principle of
glaucoma therapy is to prevent loss of visual field. Its importance cannot be emphasized strongly enough.”
Stein, Harold A., Raymond M. Stein, and Melvin I. Freeman. The Ophthalmic Assistant: A Text for Allied and Associated Ophthalmic Personnel. 9th ed. Elsevier, 2013, pp.
In light of this research and the fact that Glaucoma can slowly and silently lead to blindness without many noticeable signs, I wanted to undergo my own visual field
test, along with other Glaucoma screening tests.  Here are my test results:
Tonometry: Intraocular Pressure = 14 mmHg R/E & 13 mmHg L/E  (test completed July 25, 2014)
Optical Coherence Tomography (OCT): See Appendix A
Visual Field Testing (Perimetry): See Appendix B