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Date of Graduation

8-11-2001

Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

H. "Randy" Randolph, PA-C

Abstract

Objective: To determine if the Humphrey® Frequency Doubling Perimetry visual field analyzer can effectively find visual field defects in primary care patients, and if a specific population of patients may be at a higher risk for visual field defects. Many studies have looked at the utility of Frequency Doubling Perimetry in eye clinics and in generalized screenings, but not in a primary care patient population. This will help to facilitate earlier diagnosis and treatment if visual field defects are identified. Design: A methodological, retrospective and quantitative screening study with a visual field screening, patient survey, and a retrospective chart review. Setting: Legacy Good Samaritan Medicine Clinic, Portland, Oregon. Patients: One hundred thirty-five males (n = 52) and females (n = 83) age 40 to 92 years who were seen for a primary care appointment. Results: 35.6% of all patients screened had a visual field defect present (40.4% of males/32.5% of females). Visual field defects increased as age increased (13.3% age 40-49 vs. 60% age 80- 89). The average age of a patient with defects was 70.5 years. The average person with defects had 2.2 risk factors defined by this study. Five risk factors were strong predictors of defects (prob > chi2 = 0.1): Previous glaucoma diagnosis, diabetes, hyperlipidemia, family history of glaucoma, and migraine headache. Overall, the risk of having a defect increased with number of risk factors. African American, Asian, and "other" ethnic backgrounds had 50% of individuals with defects present. 37.8% of Caucasians and 33.3% of Hispanic/Latinos had defects present. Conclusion: The Humphry® Frequency Doubling Perimetry visual field analyzer is effective at detecting visual field defects in a primary care patient population. The presence of a visual field defect is directly proportional to age, and is affected by the number of co-morbid conditions present. Defects are independent of ethnicity or gender. Health care providers should be aware of the risk factors for ocular pathology and can use the information gathered in this study to help make their own decisions regarding which patients to screen on a regular basis.

Comments

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