Confrontation test

OPHTHALMOLOGY

1. Confrontation fields test By Dr. Alshymaa Moustafa Ophthalmology specialist

2. Visual field It contains: Centeral or foveal which is measured by visual acuity test, contrast senstivity and macular function tests .and concerned with Resolution, forms . Peripheral or Extrafoveal which is concerned with Peripheral sensitivity , motion and light detection . Normal visual field is reversed inverted map of corresponding retinal points.

3. The normal extensions of visual field are : °50 Suoerior °60 Nasal °70 Inferior °90 Temporal.

4. Perimetery It is making of visual field using stimulus . The stimulus may be Moving (kinetic) determine the visual threshold along edge of visual field. Static in which the static object has different level of brightness.

5. Confrontation fields test It is used as screening for moderate to sever visual field defects. It is un reliable to identify Mild visual field defects. Note Face to face position. Start with better eye. Avoid confusion by using 1,2,5 fingers . If the patient can’t count fingers, use hand motion , if can’t use light projection . Young child use finger mimicking procedure.

6. Correct position : 2 finger sud by side in front of the eye field. Incorrect position : One finger hide the other

7. Clinical protocol Test steps :

8. Test steps . Seat the patient and occlude the eye not being tested. Facing the patient at a distance 1 m , close your eye that is directly opposite to the patient occluded eye. Ask the patient to fixate on your nose or your opened eye.

9. Check for scotoma Finger counting : Q uickly present and retract 1finger in 1 hand in 1quadrant. Must be done 2 times in each quadrant. Repeat in 4 quadrants. Simultaneous finger counting ; Use 1,1 or 1,2 or 2,2 fingers simultaneously in opposition quadrants . Ask the patient for sum . Simultaneous comparison: Hold both palm, or identical coloured objects to words the patient close line of sight. Ask for difference in brightness or darkness. Do it central , eccentric.

10. Diagram the test Diagrams showing 3 stages of the test . If normal write Full to 3 stage confrontation or counting fingers .

11. Thanks