A new perimeter using the preferential looking response to assess peripheral visual fields in young and developmentally delayed children.
OBJECTIVE
To compare the sensitivity, specificity, and interpretability of a newly developed semiautomated static perimeter based on the preferential looking response to the results of confrontation visual field testing in a group of young and/or developmentally delayed children with and without visual field deficit.


METHODS
The preferential looking perimeter (PLP) uses observation of the child's natural eye movement response to an appearing target to determine the peripheral visual field. We compared preferential looking perimetry to confrontation testing in 74 children 3-10 years of age (mean, 6.6 years; median, 7 years), including 32 controls and 42 children with neurological and ocular disorders that could cause significant visual field deficit.


RESULTS
Using confrontation testing as the gold standard, the PLP was 100% sensitive and 100% specific (95% CI, 90%-100%), with excellent interobserver agreement. An interpretable result could be achieved in 15 (71%) of the 21 children in whom confrontation testing was unhelpful.


CONCLUSIONS
PLP is a useful new technique for assessing significant visual field loss in young or developmentally delayed children, with many advantages over confrontation testing.
University of Cambridge, The Old Schools, Trinity Lane, Cambridge, United Kingdom. louise.allen@addenbrookes.nhs.uk
Louise E
LE
Allen
Michael E
ME
Slater
Ruth V
RV
Proffitt
Elizabeth
E
Quarton
Adar
A
Pelah
D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000503:physiopathology; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D012680:Sensitivity and Specificity; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D015348:Vision, Binocular / Q000502:physiology; D058609:Visual Field Tests / Q000295:instrumentation*; D014794:Visual Fields / Q000502:physiology*