A 45-year-old woman visits the clinic complaining of an intermittent shadow in her side vision that has appeared on and off for several weeks. Before the ophthalmologist evaluates her, you are asked to screen her peripheral visual fields. Which technique should you use to assess the integrity of her side vision?
The confrontation visual field test is a quick, equipment-free method for grossly evaluating peripheral vision. The patient covers one eye and fixates on a central target while the examiner brings fingers or a small object from the periphery toward the center, noting when the patient first perceives the stimulus. This screens for large visual-field defects.
Automated perimetry requires specialized devices (e.g., a Humphrey Field Analyzer) and is usually performed by trained technicians, not in an immediate pre-exam screen. The Amsler grid is a small printed chart that evaluates the central 10-20° of vision, so it does not test peripheral fields. A Snellen chart measures visual acuity-how clearly a patient sees high-contrast letters-but provides no information about visual field extent.
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