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SUMMARY: BACKGROUND Sensitivity of confrontation visual field (CVF) screening is low unless defects are significant. We compared the sensitivity of laser pointer visual field screening (LVF) with conventional CVF for identifying eyes with abnormal automated perimetry.METHODS Ninety consecutive patients presenting for HVF prospectively underwent a masked comparison of CVF and LVF testing (175 eyes) from April to May 2000. LVF was performed using a laser pointer target projected onto a tangent screen. Points were tested in random fashion on either side of the vertical and horizontal meridians, near central fixation, around the blind spot, and in each quadrant. Single and double simultaneous finger counting was used to test CVF.RESULTS LVF demonstrated significantly greater sensitivity as compared with CVF (73% versus 31%, P = 0.001) in identifying field defects found on HVF. Specificities for LVF and CVF were 82% and 99%, respectively. The average testing times per eye were 0.5 minute for CVF, 1.5 minutes for LVF, and 8.0 minutes for HVF.CONCLUSIONS In this cohort, laser visual field testing was significantly more sensitive than confrontation testing. It may represent an effective, time-efficient tool for visual field screening. [ABSTRACT FROM AUTHOR]

Optic nerve disorders were not reliably diagnosed until the late nineteenth century when ophthalmoscopy became part of the ophthalmic examination. By the early 1900's, all of the salient clinical features of optic neuritis and its relationship to “systemic sclerosis” were recognized, but there was much controversy and misunderstanding about its differential diagnosis, pathogenesis, and possible treatment. During the twentieth century, physicians began to distinguish optic neuritis from infectious, hereditary, toxic, nutritional, and ischemic optic neuropathies. The development of magnetic resonance imaging and the results from recent clinical trials have enhanced our understanding of the relationship between optic neuritis and multiple sclerosis. The next decade holds the promise of further elaborating the pathogenesis and treatment of optic neuritis. [ABSTRACT FROM AUTHOR]