Hidden False Positives in the Visual Field

A 78 year old patient presented to the glaucoma clinic due to the detection of narrow angles and elevated IOP. The corrected visual acuity and intraocular pressure were 20/25 and 18 mm Hg in both eyes with two anti-glaucoma eye drops, respectively. The laser iridotomies were patent OU. Funduscopy showed a cup/ disc ratio of 0.5 OU and her baseline optical coherence tomography was within normal limits in both eyes. The left eye visual field reliability indices were within normal limits, however her pattern deviation plot illustrated greater defects than her total deviation plot [Figure 1]. Closer evaluation of the raw data showed exceptionally high peripheral sensitivities compared to her central thresholds. Her visual field defects did not correspond with the exam and optical coherence tomography.