Study Supports Home Monitoring of Visual Fields

Comparison of home visual-field testing and in-office Humphrey analyzer shows patient compliance.

Several studies, including the Advanced Glaucoma Intervention Study (AGIS) study, have shown that visual field (VF) testing is key in tracking glaucoma progression and can provide physicians with a valuable indicator of how much visual field is present. Although traditionally VF measurements have been conducted in the office, options have emerged that allow patients to perform the measurements from the comfort of their own home.

A single-center observational, longitudinal, and compliance study of VF-Home, published in the American Journal of Ophthalmology, has demonstrated good compliance and reliability, while also identifying barriers that would prevent patient success. The study aimed to compare VF-Home to the Humphrey visual field analyzer (HFA) on the 24-2 Swedish interactive thresholding algorithm (SITA) standard setting.

A total of 101 participants who had been diagnosed were diagnosed either as glaucoma suspects or with stable glaucoma in at least one eye were recruited for the study. A total of 186 eyes were involved in the study. An in-clinic HFA was performed at baseline and repeated in 6 months. Participants were each given an iPad and asked to perform 6 visual field examinations from home over the course of the month. The uptake was defined as receiving data from at least 1 home-performed test. Next, the reliability and global indices from VF-Home were compared with those derived from clinical testing. Participants were also surveyed about barriers to uptake.

By the end of the study, 88% of participants had successfully completed more than 1 exam at home and 69% of the participants had successfully completed all 6 exams with a median duration of 7 days between tests. The VF-Home gave greater fixation losses than HFA but showed a similar level of false-positive and a high correlation (r=0.85) between VF-Home and the HFA. Barriers to uptake and compliance included technological problems, lack of motivation, and competing life demands.

Ultimately, the study showed that the VF-Home had a high level of short-term compliance and offered results that were comparable to the HFA.

 Disclosure: Several study authors declared affiliations with pharmaceutical or other industries. Please see the original reference for a full list of authors’ disclosures. 


Prea SM, Kong GY, Guymer RH, Vingrys AJ. Uptake, persistence, and performance of weekly home monitoring of visual field in a large cohort of patients with glaucoma. Am J Ophthalmol. Published online November 18, 2020. doi: 10.1016/j.ajo.2020.10.023