Wu, John Xing-Wang; (1993) Visual screening for blinding diseases in the community using computer controlled video perimetry. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Detecting early visual impairment in a community-based approach is difficult because of the variety of light contrast in which measurements have to be made. Finding ways which are functionally efficient, and yet cost-effective, could lead to important improvements to health and quality of life. To select an appropriate visual screening test for use in multicontrast situations, requires an understanding of the interface between clinical epidemiology, visual field technology and the environment in the community where the tests are to take place. Four issues have been taken into account in the study: basic multicontrast characteristics; aspects of clinical application of motion stimuli; discriminative ability, reliability and validity to detect early visual loss, and the acceptability of the test. The study included the development of a group of software programmes called collectively Computer Controlled Video Perimetry (CCVP). The Motion Sensitivity Tests (MSTs) were developed as a part of CCVP in collaboration with Dr Fitzke for early glaucoma detection. The Motion Sensitivity Screening Test (MSST) was finally developed by using a low cost and portable notebook computer to assess acceptability. The tests were carried out on 2632 individuals, from whom 5129 CCVP tests were recorded. Testing was undertaken in a wide variety of situations that included a glaucoma clinic in an eye hospital; an eye health survey in inner city community; a glaucoma survey in an Irish rural community; mass screening for optic nerve disease in region of meso-endemic for onchocerciasis in Nigeria and a self-testing programme set up during a clinical meeting in the USA. CCVP showed that it was possible to detect early visual function loss in a wide variety of situations, whether in clinic or in the community. The results from my study provide a framework for clinical application of using CCVP technology and motion testing to be made with respect to glaucoma and optic nerve disease screening.

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