UC San Diego

Purpose

To illustrate the potential role for Heidelberg edge perimetry (HEP) in the assessment of early functional loss in glaucoma.

Case report

A 46-year-old male presented with raised intraocular pressure but healthy optic discs and normal standard automated perimetry (SAP). He was diagnosed with ocular hypertension, but after 16 years, he developed glaucomatous changes to the right optic disc and inferior retinal nerve fiber layer thinning. Despite the evidence of progressive structural damage, functional testing using SAP was repeatedly normal, based on conventional criteria. HEP, on the other hand, revealed an extensive superior visual field damage in agreement with the structural changes. Additionally, and in contrast to SAP, the HEP indices of Glaucoma Hemifield Test, mean deviation and pattern standard deviation were all outside normal limits.

Conclusion

This case illustrates that HEP may have an important role in the early detection of functional damage in glaucoma, with potential advantages over SAP.