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The investigation of visual field is an essential component of any eye examination as it may detect both early ocular and neurological disease processes which other investigations may miss. Detailed and accurate field screening or investigation is a subject covered in depth elsewhere.1 Such detailed examinations, though essential, are often not included as part of the basic routine examination and are instead considered supplementary tests.
However, because of the significance of the presence of any previously undetected major field loss, a routine should include at least one gross assessment of the visual field as any major defect not only emphasises the need for a more detailed field assessment, but may change the priority of other tests. A large and previously undetected hemianopia should make the practitioner consider referral rather than spending unnecessary time on subjective refraction, for example. It might also be argued that in many cases, this gross assessment is the only assessment of the peripheral field that is to be carried out, most modern screeners assessing only the central 25 to 30 degrees. Though it is true that around 85 per cent of field defects fall within this space, the remaining minority affecting the intermediate and far periphery are often of significant clinical relevance.
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