Visual Field Defects in Open-Angle Glaucoma: Progression and Regression

  • Charles D. Phelps
Part of the Documenta Ophthalmologica Proceedings Series book series (DOPS, volume 19)


How often do glaucomatous visual field defects improve or worsen? What factors predispose a glaucomatous eye to changes in the visual field? Attempting to answer these questions, I reviewed the charts of 130 patients (177 eyes) who met the following criteria: open-angle glaucoma, definite glaucomatous visual field defects, good visual acuity, reliable responses during perimetry, and two perimetric examinations one year apart. Patients were separated into three groups: a surgical group, a group newly started on medical treatment, and a control group continued on previous medication. Visual fields were tested on the Goldmann perimeter, using Armaly’s strategy of ‘selective perimetry’ for detection of defects and quantitative kinetic perimetry for their assessment.

Visual fields improved in 7% and worsened in 15% of the 177 eyes. Improvement occurred more frequently in young patients, in eyes treated surgically, when the reductions of intraocular pressure were large, and when the cup of the optic disc did not extend to its rim. Worsening occurred more often in old patients and in eyes treated medically. Neither systemic blood pressure nor severity or location of visual field defects influenced the prognosis.


Visual Field Intraocular Pressure Optic Disc Visual Field Defect Ocular Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Armaly, M.F. The visual field defect and ocular pressure level in open-angle glaucoma. Invest. Ophthalmol. 8: 105–124 (1969).PubMedGoogle Scholar
  2. Armaly, M.F. Selective perimetry for glaucomatous defects in ocular hypertension. Arch. Ophthalmol. 87: 518–524 (1972).PubMedGoogle Scholar
  3. Demailly, P.L., Papoz, L., Valtot, F. Trabeculectomy versus medical treatment in chronic open-angle glaucoma: First results after 16 months follow-up. International Glaucoma Symposium, Albi, May 20–24, 1974, ed. by R. Etienne and G.D. Paterson, Diffusion Générale de Librairie Marsaille, pp 451–460 (1975).Google Scholar
  4. Drance, S.M., Brais, P., Fairclough, M., Bryett, J. A screening method for temporal visual defects in chronic simple glaucoma. Canad. J. Ophthalmol. 7: 428–429(1972).Google Scholar
  5. Drance, S.M., Bryett, J., Schulzer, M. The effects of surgical pressure reduction on the glaucomatous field. Second International Visual Field Symposium, Tübingen, September 19–22, 1976, ed. by E.L. Greve, Dr. W. Junk by Publishers, The Hague, pp 153–157 (1977).Google Scholar
  6. Greve, E.L., Dake, C.L., Verduin, W.M. Pre-and post-operative results of static perimetry in patients with glaucoma simplex. Documenta Ophthalmologica 42: 335–351 (1977).CrossRefGoogle Scholar
  7. Heilmann, K. Progression and regression of visual field defects. Glaucoma: Conceptions of a Disease, ed. by K. Heilmann, K.T. Richardson, George Thieme Publishers, Stuttgart, pp 168–175 (1978).Google Scholar
  8. Janotka, H., Dubiel, J. Ergebnisse der operativen Behandlung bei chronischem Glaukom mit grösseren Gesichtsfeldausfällen. Klin. Mbl. Augenheilk. 170: 105–108 (1977).PubMedGoogle Scholar
  9. Patterson, G. Effects of intravenous acetazolamide on relative scotomas and visual field in glaucoma simplex. Proc. Roy. Soc. Med. 63: 865–869 (1970).Google Scholar
  10. Smith, R-J.H. Medical versus surgical therapy in glaucoma simplex. Brit. J. Ophthalmol. 56: 277–283 (1972).CrossRefGoogle Scholar
  11. Werner, E.B., Drance, S.M. The effect of trabeculotomy on the progression of glaucomatous visual field defects. Second International Visual Field Symposium, Tübingen, September 19–22, 1976, ed. by E.F. Greve, Dr. W. Junk by Publishers, The Hague, pp 67–73 (1977).Google Scholar

Copyright information

© Dr W. Junk bv Publishers 1979

Authors and Affiliations

  • Charles D. Phelps
    • 1
  1. 1.Department of OphthalmologyUniversity HospitalsIowa CityUSA

Personalised recommendations