Will Perimetry Be Performed to Monitor Glaucoma in 2025?

Visual field testing has played an essential role in the diagnosis and management of glaucoma for more than a century. Methods to examine the visual field have been refined from early kinetic perimetry to current standard automated perimetry (SAP). Clinicians now use SAP for the diagnosis and management of glaucoma throughout the world. Various testing paradigms and analytic methods have been developed to simplify the diagnosis of glaucoma and the interpretation of progression. Moreover, strategies have been implemented to improve patient experience with visual field testing and to increase reliability. Objective functional tests, such as electroretinography, provide an alternative to subjective visual field testing but are not yet ready for widespread adoption. Standard automated perimetry is being adapted and improved constantly. New devices may allow patients to complete visual field tests at home, which could relieve patients and clinicians from in-office testing and allow for more frequent examinations. Glaucoma detection and progression analysis also are incorporating progressively more information and will be improved as deep learning strategies are applied. Finally, perimetric and structural testing likely will become more closely intertwined as testing platforms and progression analysis incorporate both of these measures. Visual field testing will continue to have an important role in the diagnosis and management of glaucoma.