A More Engaging Visual Field Test to Increase Use and Reliability in Pediatrics

Grant Winners

Dean

Abstract

The majority of young children do not think that visual field (VF) testing of peripheral vision is similar to a game [Marraffa et al. 1995]; therefore, it is not surprising that they have difficulty maintaining attention during VF testing and thus the test reliability suffers as a consequence. Poor VF reliability has been a longstanding, major issue since it leads to an increased number of tests and/or longer duration of time needed to determine when there are true vision losses. Another downfall is that providers are less likely to obtain VF tests in children since the results are of doubtful value and challenging to interpret when they are inconsistent. Effectively this means that children with untreated, slowly progressive eye diseases may go undiagnosed and incur greater visual losses. We aim to create a prototype device that we hypothesize will make VF testing more engaging for young children, thus increasing their attention and consistency of their responses to the test stimuli, which in turn should improve VF reliability. The components include a microdisplay video screen (1.5î diameter) as the fixation target (instead of the standard LED light) displaying video clips of popular cartoon characters, and audio clips of impersonated cartoon character voices presented by the test operator to provide instructional feedback based on the child's performance during testing. We will determine test-retest reliability during two VF tests a week apart in 5-8 year olds suspect for juvenile glaucoma or optic nerve abnormalities. We will randomize half to receive the intervention and compare to others randomized to usual care during VF testing (routine clinical procedures; control group). Improved VF reliability from our intervention would translate to improved diagnosis and care for young children's peripheral vision loss through widespread implementation of our innovative, affordable and readily adoptable system at eye care providers' offices.