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Br J Ophthalmol. 2007 June; 91(6): 845.
PMCID: PMC1955575

Visual Fields via the Visual Pathway

Reviewed by Paul G D Spry

Fiona Rowe, Published by Blackwell: Oxford, 2006, $69.95 (paperback), pp 224. ISBN 1405115254

Assessment of the visual field is indicated for three important reasons, (1) accurate initial identification of real sensitivity deficits; (2) detection of progressive defects; and (3) aiding differential diagnosis. The primary role of Dr Rowe's new textbook is to assist with the third of the above‐mentioned reasons, and is aimed squarely at both students getting to grips with interpreting visual field test results for the purpose of informing their clinical practice and those practitioners wishing to refresh their knowledge. It adopts a strong clinical interpretative and diagnostic stance.

Visual fields via the visual pathway is a basic guide describing the relationship between lesions in the visual pathway and their associated visual field defects. The approach is well structured and systematic, following the visual pathway sequentially from eye to brain. Each section of the pathway is treated to its own chapter. In each chapter, anatomy is briefly summarised, and pathologies most likely to affect the given part of the pathway are classified and listed. Associated signs and symptoms that accompany such lesions are described. Then, for each condition, the expected visual field defects are explained and accompanied by numerous supportive examples. Wherever appropriate, scans and photographs embellish the field test results. Supporting chapters include introductory text on perimetric parlance, methods of testing, test programme choice, differential diagnosis, artefacts and errors of interpretation, and a useful glossary.

The major benefit of this particular text is its emphasis on the use of visual field test results as key clinical information for differential diagnosis. To achieve this, it concentrates on outputs from today's most commonly used instruments, the Humphrey field analyser (HFA) and the Goldmann bowl perimeter. Sufficient information on the design and basic psychophysics underpinning these instruments is provided to enable the reader to understand their outputs.

Potential buyers and readers of this book should be aware that all examples and interpretive aids provided in this book assume that the readers will be using the HFA and/or Goldmann instruments. They should also note that, except for the suggestions for further reading, details on the science or research underpinning perimetry are limited to the extent required to describe the instruments and specific tests that these instruments offer. There is no discussion of more recently designed perimetric tests that use non‐standard stimuli. Finally, this book is not a guide on how to physically perform perimetry, although many useful hints are provided in the context of interpretation.

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