Comparison of Kinetic, Automated, Tangent Screen, and Novel Disposable Perimetry for the Evaluation of Dermatochalasis and Blepharoptosis.

Abstract

Purpose: To compare a novel disposable ptosis visual field device to conventional perimetry devices for the evaluation of dermatochalasis and/or blepharoptosis.

Methods: Forty patients from a single academic center participated in this prospective, observational study. Patients with dermatochalasis (skin resting on the eyelashes) and/or blepharoptosis (marginal reflex distance 1 ≤2 mm) were included. Each subject underwent untaped and taped perimetry using 4 visual field devices in random order: Goldmann visual field (GVF), automated Humphrey visual field (HVF), tangent screen (TS), and the novel visual field device (NVF). One eye was randomly selected, and McNemar tests and paired t tests were used to establish comparisons between devices.

Results: The mean difference between untaped and taped central perimetry (in °) in the GVF, NVF, HVF, and TS was 26.5° ± 14.0°, 12.4° ± 8.5°, 9.6° ± 6.5°, and 9.6° ± 5.8°. The novel device detected a mean 2.9° greater difference than both the HVF (p = 0.083) and the TS (p = 0.062). The GVF, NVF, HVF, and TS detected a ≥12° difference in 90%, 50%, 39%, and 32.5% of eyes, respectively. The GVF detected a mean 14.1° greater difference than the novel device (p < 0.001). The GVF, NVF, HVF, and TS detected a ≥30% superior field occlusion in 98%, 73%, 55%, and 50% of eyes, respectively. There was no statistical difference in the ability of the NVF to detect a >12° difference or ≥30% superior field restriction compared with HVF or TS.

Conclusions: The NVF is as reliable as the commonly used HVF and TS for the evaluation of visual obstruction due to blepharoptosis and dermatochalasis. The GVF is more sensitive than the other 3 devices. The novel disposable visual field device could allow for virtual visual field testing.