- Design
- Retrospective record-based study, tertiary centre, central India
- Population
- 383 reliable Humphrey 30-2 fields from 1,438 tests, 2023–2025
- Primary outcome
- Diagnostic yield for neurological disease
- Effect
- Confirmed neurological disease 52.2% vs 1.9%; abnormal fields 58.4% vs 26.8%, OR 3.84 (2.48–5.95)
This retrospective study from a tertiary centre in central India, published in the Indian Journal of Ophthalmology on 29 September, reviewed Humphrey 30-2 visual fields done between 2023 and 2025. Of 1,438 tests, 383 met reliability criteria.
Fields were abnormal in 58.4% of tests done for neurological indications and 26.8% of others (OR 3.84). Neurological disease was confirmed in 52.2% of neurological referrals against 1.9% of others. The commonest patterns were bitemporal hemianopia (23.5%), homonymous hemianopia (19.7%) and central scotoma (16.7%), with more than 90% agreement with imaging.
Most 30-2 fields in eye clinics are ordered for glaucoma, and the neurological pattern can be missed when the eye looks normal. Only about a quarter of all tests met the study's criteria, which included reliability limits, a reminder that a field is only as good as its reliability indices.
- Order a 30-2 field when unexplained visual loss comes with a normal-looking eye.
- Look for field defects that respect the vertical meridian; they point to the chiasm or beyond.
- Arrange neuroimaging for bitemporal or homonymous defects.
- Check reliability indices before interpreting any field.
- Repeat unreliable fields rather than acting on them.
Why it matters
A test ordered mostly for glaucoma found neurological disease in half of the patients referred for it.
Don't overread it
Referral patterns shaped the yield; this was a selected tertiary population.
The statistics, in plain English
An odds ratio of 56.6 with an interval from 17.4 to 184 is very large but imprecise because only 3 non-neurological referrals had neurological disease. The direction is clear; the exact size is not.
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