Page 28 - BOAF Journal 1 2012:2707

Behavioral Optometry
BOAF
Volume1 Number1 2012
different color marking pencil with each size test object to show the signs of field changes in a more obvious manner (See Figure6.)
The direction of movement of the test object for pathologi- cal scotomata chartings is from non-seeing to seeing in order to obtain the greatest possible evidence of the defect. (See Figure No.5.)
Fig.5
The conversation to the patient for pathology detection is, „This time I am going to make the silver ball reappear. Continue to look at the yellow light at all times but watch for the silver ball out of the corner of your eye and say ,now‘ as soon as it appears.“
In any search for pathologi- cal scotomata, a very slow brushing motion with the mar- net arm back and forth over the entire paracaecal area using the 1.00 m/m, 0.79 m/m, or the 0.50 m/m test object is per- formed. (See Figure No.7.) You should instruct the patient to inform you if the test object fades or blacks out of their vi- sion at any time. At such time, you then start within the sco- toma and plot it carefully from the non-seeing to seeing. If this search is as a result of signs or symptoms of glaucoma, it should be made in the area most common to scotoma due to glaucoma which is in an arc from the superior and inferior
border of the blind-spot in a ring toward the superior nasal and inferior nasal fields respectively. Fig.6
Figure No.6 illustrates how the signs of the field changes are made more obvious by using first the 1.00 m/m test object, then the 0.79 m/m, and then the 0.50 m/m.
Fig.7
Figure No.7 illustrates the slow brushing motion direction to be used in any search for pathologi- cal scotomata.
Fields changes associated with glaucoma usually appear in the following order:
Fig.8
Figure No.8 illustrates a general enlargement of the blind-spot with a slight bulge in the nasal portion of the right eye.
Fig.9
Figure No.9 represents a widen- ing of the angioscotoma tree.
Fig.10
Figure No.10 illustrates the fre- quently found juxtacaecal step. The 0.79 m/m or 0.50 m/m test object should be used when searching for this.
Fig.11
Figure No.11 paracaecal sco- tomas on both the right and left eye.
Fig.12
Figure No.12 shows a Seidel‘s sign on both the right and left eye. This is usually an elongation in the beginning of an arc or crescent extending from either the inferior or superior border of the physiological blind spot and usually accompanied by general enlargement.
Fig.13
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