Pain and vision loss during visual field exam

[DMD74]

Hi!  I'm hoping someone might be able to help me,  since my regular doctors can't seem to figure out what's happening.  I'm a Type1 Diabetic with Retinopathy that is stable, and I have also been a glaucoma suspect for 10 years due to high pressures.  For the past year I've been having problems when I take Visual Field Exams.  I'm ok when when the patch gets put over one of my left eye and the exam starts, but soon the problem begins wit pain and irritation in my right eye, and gets worse as the exam goes on.  My vision deteriorates and the pain worsens so that I can't continue.   I'm not just seeing an optometrist, this is happening with specialists treating me at a university med center, but they don't understand why it's happening and insist on continuing these tests that are causing so much pain and affecting my normal vision following the test.  I can give further details if you have any idea why this is happening or can direct me to resources to figure this out.  Thanks for any help :)

[Doreen Fazio, M.D.]

One possibility is the occurrence of angle closure with high eye pressure during the visual field exam, because the pupil may dilate during the test.  Drying of the cornea is another possibility, if you are staring during the test and not blinking enough.  I would be sure your doctor does a gonioscopy to check the anterior chamber angles, and also an OCT test of the anterior chamber angles.  If the angle (space between iris and cornea) is judged to be very narrow and occludable, a laser procedure called an iridotomy is indicated.  If your anterior chamber angles are open on gonioscopy and OCT, you may try putting in artificial tears before the visual field test, and several times during the test. You may pause the field test by holding down on the button.

[DMD74]

Thank you so much for the information Dr. Fazio!  The med center staff just keeps telling me that the test should be a painless procedure and that it's necessary for preventing the glaucoma getting worse, but don't seem to understand how it could be causing me so much pain.