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Humphrey visual field test 30-2 brightest stimulus decibels 0 dB 10000 apostilbs

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automated perimetry visual field testing

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https://www.ncbi.nlm.nih.gov/books/NBK585112

  1. Left eye field: Left temporal hemianopic field defect, respecting the vertical meridian.
  2. Ophthalmic examination: Examine the pupils carefully for a relative afferent pupillary defect (RAPD), particularly in the left eye. Also assess visual acuity, colour vision, optic discs for optic atrophy, and perform a full fundus examination.
  3. Site of lesion from both fields: The combined fields show a left homonymous hemianopia. The defects appear incongruous, which points to a lesion in the right optic tract rather than a more posterior retrochiasmal lesion. Optic-tract lesions can produce a contralateral RAPD, here in the left eye. Localization in Clinical Neurology, 8e, p. 359. Homonymous hemianopia results from a lesion behind the optic chiasm. Harrison's Principles of Internal Medicine, 22e, p. 265.
  4. Brightest stimulus intensity: 0 dB. On the Humphrey Field Analyzer scale, 0 dB is the maximum-brightness stimulus, equivalent to 10,000 apostilbs (about 3,183 cd/m²), as explained in the Zeiss perimetry primer.

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Humphrey field analyzer 0 dB brightest stimulus 10000 apostilbs official Zeiss

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binasal hemianopia optic chiasm

  1. Left eye visual field:
    Temporal hemianopia of the left eye.
  2. Ophthalmic examination to do:
    • Visual acuity and refraction
    • Pupillary reactions, including RAPD
    • Colour vision
    • Fundus examination, especially optic discs for primary optic atrophy
    • Ocular movements and cranial nerve examination
    • Repeat/confirm visual fields and assess for features of optic chiasmal compression
  3. Site of lesion:
    The two fields together show bitemporal hemianopia, indicating a lesion at the optic chiasm, most commonly compression from below by a pituitary adenoma. Neuroimaging with contrast MRI of the pituitary/sella is indicated.
  4. Brightest stimulus used in Humphrey perimetry:
    0 dB, corresponding to the maximum stimulus intensity of 10,000 apostilbs.
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