Feasibility of saccadic vector optokinetic perimetry: a method of automated static perimetry for children using eye tracking.

PURPOSE To determine the feasibility of a new technique for suprathreshold automated static perimetry in children. DESIGN Evaluation of diagnostic test or technology. PARTICIPANTS The study included 29 subjects comprising 4 groups: 12 adults with normal fields, 4 children aged less than 10 years with normal fields, 8 adults with visual field defect, and 5 children aged less than 10 years with suspected visual field defects. METHODS The system comprises a personal computer, display, and eye tracker to monitor gaze position when stimuli are presented in the visual field. The natural saccadic eye movement to fixate on the stimuli, if seen, can be detected and measured to produce a visual field plot. Subjects performed 3 eye-tracking tests, unless unable to do so for any reason: a 40-point binocular test and two 41-point tests for each eye. The tests were based on the Humphrey Field Analyzer (HFA) Central-40 point screening test with a stimulus size of Goldmann III and intensity of 14 decibels (dB). Adults also performed the equivalent Humphrey screening test in each eye for comparison. MAIN OUTCOME MEASURES Comparison of visual field plot results between the eye-tracking tests and HFA tests in adults. Correlation between the eye-tracking tests and the clinical assessment in the children with suspected visual field defects. RESULTS In the eyes of all normal adult and child subjects performing the eye-tracking test, the percentage of points in agreement with a healthy visual field was 99.2% and 99.1%, respectively. The percentage of points agreeing with the HFA's screening test in the adult eyes with visual field defects was 89.8%. Visual field defects were also correctly identified by the eye-tracking system in the eyes of children with suspected visual field defects. CONCLUSIONS The results demonstrate that suprathreshold automated static perimetry using eye tracking is a promising method of perimetry for use with children.

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