[Confrontation test using Bagolini striated glasses--a new screening method for detection of quandrantanopia and hemianopia].

BACKGROUND

To propose a quick test using striated lens according to Bagolini for detecting quadrantanopic and hemianopic visual field defects.

PATIENTS AND METHODS

The results of this test are presented and compared with Goldmann perimetry in five patients suffering from quadrantanopic and hemianopic visual field defects in hypophyseal adenoma (2 x quadrantanopia, 1 x bitemporal hemianopia) and occipital process (2 x homonymous hemianopia). To examine the visual field the patient has to fixate a light at 50 cm distance. Due to the striated glasses two light stripes are generated along the 45 degrees diagonal, crossing in the fixated light in normal binocular vision. The temporal lower and nasal upper quadrants of both eyes and after switch the striated glasses around the horizontal axis, the nasal lower and temporal upper quadrant of both eyes can be tested along the 45 degrees axis. While fixating the lamp the patient is asked (in normal binocularity identical with the crossing point), if one or more of the four light stripes, beginning at the crossing point is shorter or weaker than the others, or interrupted or missing totally.

RESULTS

Shortened or absent light stripe indicating quadrantanopic visual field defect agrees with the location of visual field defect in kinetic Goldmann Perimetry. An absent light stripe indicates a complete quadrantanopia, a shortened light stripe an incomplete quadrantanopia. Fixation is warranted easily by the crossing light stripes.

CONCLUSION

The dissociation with the aid of striated glasses allows a simultaneous test of both eyes in the 45 degrees-axis of all four quadrants in combination with the location of the visual field defect in this axis. The proposed confrontation test is a simple and quick test without extensive equipment. This test seems to be a useful tool in detecting homonymous or heteronymous quadrantanopic and hemianopic visual field defects for quick screening purposes, especially in immobile patients.