Graefes Archly 200, 21-37 (1976) Graefes Archiv for klinisehe und experimentelle Ophthalmologie , 9 by Springer-Verlag 1976 Automatic Perimetry in Glaucoma Visual Field Screening A Clinical Study Anders Heijl Department of Experimental Ophthalmology (Head: Professor C.E.T. Krakau) University Eye Clinic, S-221 85 Lund, Sweden Summary. Automatic computerized perimetry was compared to careful manual selective perimetry (a variant of that proposed by Armaly) in 181 eyes of 100 patients from a glaucoma open-care unit. The results of the two methods were very similar. Thus all defects found were identified by the automatic perimeter, and one pathologic field was missed by the manual selective perimetry. The automatic examination gave 16% false positive results and the manual 11% when optimally performed. The false positives could be greatly reduced (to 4.4% and 3.3% respec- tively) by rescreening. In a comparison with "routine" perimetry, the automatic screening is shown to be superior. Zusammenfassung. Automatische computergesteuerte Perimetrie wurde mit sorgf~il- tiger manueller selektiver Perimetrie (einer Variante der von Armaly vorgeschlage- nen), verglichen. 181 Augen yon 100 Patienten einer Glaukom-Poliklinik wurden untersucht. Die Ergebnisse beider Methoden waren sehr ~ihnlich. Alle gefundenen Defekte wurden durch die automatische Perimetrie entdeckt, ein pathologisches Gesichtsfeld dagegen wurde bei der manuellen selektiven Perimetrie nicht gefun- den. Die automztische Priifung ergab in 16 % falsche Resultate, die manuelle, unter optimalen Bedingungen, 11%. Die falschen positiven Resultate konnten durch erneutes Screening-Verfahren deutlich reduziert werden (auf 4.4 % bzw. 3.3 %). Ver- glichen mit der ,,Routine"-Perimetrie hat sich das automatische Screening-Verfahren als die bei weitem vorteilhaftere Alternative erwiesen. In the last few years several automatic perimeters have been presented (references in Heijl and Krakau, 1975a; further references, Chaplin et al., 1973 ; Pashley, 1974; Grignolo et al., 1975). So far no clinical study of applied fully automatic perimetry has been published, with the exceptions of the small studies of Pashley (1974) and Heijl and Krakau (1975b). Current opinion on early visual field defects in glaucoma has been formed mainly by Aulhorn and Harms (1967). When recognizable these defects are small, circum- scribed, deep scotomas, which may appear anywhere in the central visual field. A selective perimetry for glaucoma visual field defect detection, based mainly on static