Upon completing a 15-year analysis of 198,843 visual field (VF) tests, Israeli researchers found that there is a growing trend for using these tests for indications other than glaucoma. In addition, they note that adherence to glaucoma management guidelines on VF tests is suboptimal, which can lead to discernible underuse. 

This population-based, retrospective cohort study included 93,617 members of Maccabi Healthcare Services who underwent at least one VF test between January 2000 and December 2014. All patients with glaucoma or suspected glaucoma diagnosis or who were prescribed anti-glaucoma medications were evaluated. The main outcome measure was VF performance rates. 

Of the total VF tests, 47.9% involved patients without any glaucoma-related conditions. The team observed a growing trend over time of non-glaucoma patients undergoing VF tests, and, by 2014, they found that non–glaucoma-related members comprised 74.0% of new VF assessments. In contrast, they note that 32.3% of glaucoma-related patients did not undergo a single VF test throughout the entire study period.

Based on their findings, the researchers recommend establishing guidelines for VF assessments in non-glaucoma patients and improving adherence to existing glaucoma management guidelines.

Ben-Artsi E, Goldenfeld M, Zehavi-Dorin T, et al. Overuse and underuse of visual field testing over 15 years.  J Glaucoma. April 9, 2019. [Epub ahead of print].