Dr George Kong
Glaucoma is the leading cause of irreversible blindness worldwide. Sadly, significant amounts of peripheral vision can be lost before a person with glaucoma notices symptoms. For patients with glaucoma, early detection of any worsening of visual field is critical to their management. However the current practice of visual field testing in clinic is often not frequent enough, and some patient’s vision can deteriorate before their next routine clinic visit; this can lead to a delay in confirming any changes in clinical condition, and result in a delay in initiating new treatments.
During COVID-19 period, this problem has been exacerbated by many routine glaucoma reviews being postponed. Therefore it has been extremely valuable for Glaucoma Australia to provide the critical research funding to look into innovative Telehealth technology that helps patients with glaucoma to monitor their own visual field at home.
Previous research from my research team showed that it is possible to test visual field using specially designed software, Melbourne Rapid Fields, running on computer/tablet devices that are found in most Australian households.1-2 The software is designed to allow self-directed visual field testing by following simple computer voice guidance. The Glaucoma Australia funding allowed our team to conduct the world’s first long term (18-month) study to examine whether patients with glaucoma are able to perform visual field testing at home reliably and consistently, following an earlier pilot study showed promising results.
To date, we have recruited more than 60 patients for this study and some patients have completed 12 months of monitoring. Our study showed that after a short learning curve, the visual field test results obtained from home correlates strongly with test results performed in clinic. Importantly, during the COVID-19 period all participants were able to continue the study uninterrupted.
The results from visual field monitoring provide much more enriched information about a patient’s vision for their doctors during Telehealth consultations. This technology will especially benefit patients living in rural and remote locations, who would otherwise, need to travel long distances for specialist care. It is hoped that this research could lead to earlier detection of glaucoma progression compared to standard clinic visits, allowing those most in need to receive specialist treatment in a timely manner; thereby increasing the likelihood of preserving sight for more patients with glaucoma.
1. Kong YX, He M, Crowston JG, Vingrys AJ. A Comparison of Perimetric Results from a Tablet Perimeter and Humphrey Field Analyser in Glaucoma Patients. Translational Vision Science & Technology. 2016; 5(6):2.
2. Kong YXG. Visual field testing in the era of portable consumer technology, Clinical and Experimental Ophthalmology. May 2018.