IPoster: Dilation or No Dilation for Threshold Visual Field Testing: Optometric Practice Patterns

Purpose: Differences in philosophy for visual field (VF) testing have been noted. The purpose was to assess whether optometrists dilate their patients prior to threshold VF.

Methods: An electronic survey was sent to: Deans of the Schools/Colleges of Optometry, American Academy of Optometry Comprehensive Care Section members, Illinois College of Optometry faculty, as well as posted on ‘ODs on Facebook’. Those who received the survey link were asked to share it.

Results: There were 632 who completed the survey. They reported graduating from 22 different Optometry schools/universities (highest ICO 14%) and practicing in 47 states (highest California 12%), DC, Puerto Rico, Canada and 12 other countries . The highest % reported being in practice for 20 yrs. and 22.2% 10-20 yrs. Modes of practice included: private practice (34.7%), education (30.7%), governmental (17.9%), OD/MD (8.6%), commercial (3.2%), other (3.1%) and HMO (1.7%). The highest proportion (49.7%) reported they dilate some time for VF testing while 42.4% reported they do not dilate and 7.9% reported they dilate all patients. For those who dilate patients some or all of the time, reasons included: so dilated fundus evaluation could be performed (69.2%), pupil size (53%), consistent previous VF (42.6%), ocular diagnosis (27.2%), age (12.6%), and consistent with education (9.3%). For those who do not dilate patients, reasons included: unnecessary (65.7%), consistent with education (54.1%), inconvenient to patient (21.3%), and time consuming (13.8%). Most reported their philosophy has not changed (70.1%). However of those whose philosophy has changed, most (65.6%) reported less dilation. The majority (84.8%) reported managing glaucoma. Most (67.4%) order 20.

Conclusion(s): Practice patterns for VF and reasoning varied among the wide variety of respondents. Further research is needed to provide guidance in this area.