Confrontational Field-Testing

Purpose

• Used to assess each eye separately to determine the extent of the peripheral visual field.

Setup

• Position the patient to sit directly across from the examiner, about one arm's length away.
• Ensure both you and the patient are sitting so that your eyes are at the same level. This alignment ensures similar visual fields.

Preliminary Steps

• Confirm central vision is intact using prior visual acuity testing.

Testing Method: Finger Counting

1. Covering Eyes:
   • Examiner covers left eye and checks the patient's central vision by asking if the entire face is clear.
   • Instruct the patient to cover their left eye and fixate on the examiner's nose with their right eye.
   • Examiner should close their right eye to match the patient's visual field.
2. Finger Counting:
   • Ask the patient to count the number of fingers the examiner is displaying within the peripheral field.
3. Repeat:
   • Repeat the process with the other eye (patient covers their right eye, examiner closes left eye).

Alternative Method: Finger Wiggling

• Ask the patient to identify when they see the examiner's finger wiggling while maintaining focus on the nose.

Visual Field Defects

• Certain field defects can indicate specific areas of damage along the visual pathway.
• Understanding the relationship between field defects and damage is essential for diagnosis.

Notes

• Ensure clear communication with the patient to ensure accurate results.
• This testing helps identify potential visual field defects associated with specific areas of damage.