Perimetry as a technique from the standpoint of practicing ophthalmologists

Abstract

PURPOSE. To study the needs of practical ophthalmologists concerning the functionality and performance of automatic perimeters, and offer a possible solution to meet these needs.METHODS. An online survey of Russian ophthalmologists was organized and conducted. The survey was attended by specialists representing various medical institutions and medical research centers. As a result of the survey, 132 filled questionnaire forms were received and analyzed using the Kano and 4C models.RESULTS. According to experts, it is necessary for ophthalmologists to have an accessible automatic perimeter equipped with the screening (for the initial examination of patients) and threshold (to clarify the depth of photosensitivity disturbance of detected visual field defects) strategies. The general requirements for the functional characteristics of the screening and threshold tests of the automatic perimeter have been determined: small variability of repeated results, the speed and simplicity of the study — particularly, by employing the Frequency Doubling Technology (FDT), a non-standard perimetry technique. The requirements of users for the operational method of the automatic perimeter have been determined: absence of the need for a specially prepared room and place, mobility, portability, maximum ease of use to ensure the possibility of performing screening and primary diagnostics outside medical institutions, including by mobile medical teams, and also to allows examinations of individuals with disabilities, including bedridden patients, both in the hospital and at home.CONCLUSION. Based on the study data, the needs of ophthalmologists in the functional and operational characteristics of modern automatic perimeters were identified showing that the automatic perimeters presently used by modern medical institutions are far from optimal in terms of their properties/characteristics. These devices do not allow perimetry to be performed on patients with disabilities, including bedridden patients, neither at home nor in the hospitals. In addition, these devices require a darkened room, they are difficult to use, while their licensing documentation states that only ophthalmologists can conduct the examinations. Manufacturers do not offer solutions tailored to the individual needs of specific user groups — outpatient ophthalmologists who in particular work with disabled patients.