M&S Technologies News
Why Neighborhood Cluster Testing is so Important in Conducting Visual Field
Paul Harris, OD, FCOVD, FACBO, FAAO, FNAP
Professor, Southern College of Optometry
Technology has tremendously impacted our personal and professional lives. For eye care practitioners (ECP), the addition of digital hardware and software applications has transformed procedures which previously ran the same preset routines on everyone, to currently being responsive to the needs of the patient and the doctor by employing more efficient and accurate test procedures. Early in the ECP’s transition to digital testing systems the move from paper eye charts to computerized vision testing systems brought standardized methods, improved testing through randomization of optotypes, and consistency from visit to visit.
Today, one of the newest technologies that is raising the bar for vision testing is the use of the Virtual Reality (VR) Headset. What began as a direct copy of the visual field test procedures conducted by traditional bowl perimetry devices has evolved into using the advantages and flexibility of a portable, user-friendly, and accurate VR Headset. Initial advances over dedicated systems include using a VR Headset for speedy, comfortable binocular testing, the efficient completion of testing remotely, and simultaneous testing of 2 or more patients. The opportunities to transform vision testing abound with the VR Headsets; especially with their ability to add advanced testing protocols and statistical analysis methods.
One of the more transformative changes launched with the M&S VR Headset platform was the use of the “neighborhood cluster” testing approach for conducting visual fields. The neighborhood testing approach directly addresses the concern that today’s visual field testing concentrates on evaluation of single test points that are mostly regarded as being independent. However, visual field loss typically occurs in clusters of patterns and shapes that are directly related to the anatomical arrangement of structural properties of the visual system. Additionally, this means that the distribution of visual sensitivities is definitely not independent. The M&S visual field approach in the headset essentially tests at a given location and combines this information with neighboring positions in the cluster to characterize the shape and pattern of visual impairment regions. This approach will require fewer presentations to make the determination of their exact levels of sensitivity. Therefore, directing procedures that are focusing on neighborhoods or clusters rather than individual points defines the visual field forest rather than the trees, which is exactly how clinicians interpret visual field results.
What’s next in the world of VR Headsets? It’s sure to be another technological advancement that will make ECP’s lives easier and more productive as well as our patient’s lives and vision care better.