Once glaucoma occurs, is there visual field damage? A: No. Glaucoma is a chronic progressive disease, primarily involving the loss of retinal ganglion cells, which can lead to characteristic visual field defects. Because visual field examinations are not very sensitive, in some early stage patients, they can show only enlarged optic discs and thinning of the nerve fiber layer, but the visual field examination can be completely normal. In other patients with closed-angle glaucoma, there can be only atrial angle closure and elevated intraocular pressure in the early stages, and visual field damage in the later stages. Can visual field damage be detected by visual field examination whenever it occurs? A: Yes. Visual field examination is currently divided into two categories: static visual field and dynamic visual field, static visual field is also known as computerized visual field, commonly used in the central 30 degrees of visual field examination, mainly in the early and middle stage patients, sensitivity and specificity is relatively high; dynamic visual field, commonly used in the peripheral visual field examination, mainly in the middle and late stage patients. Of course visual field examination is a psychophysical examination that requires the cooperation of the patient, the patient’s understanding and cooperation is very important to the accuracy of the examination results or not, usually the first time to do visual field examination results will be less reliable, solid vision loss, false negatives, false positives and other situations, usually need to repeat twice or even three times. What descriptions appear on the visual field test report that mean it may be glaucoma? A: Different visual field meters have slightly different descriptions of the results. There are two kinds of static visual field meters commonly used internationally, Humphrey and Octopus, which generally mainly look at the correction deviation map, MD value, PSD value, etc. If there are paracentral dark spots, supra-nasal and infra-nasal bowed dark spots or defects, and the damage to the visual field is consistent with the fundus manifestation, the possibility of glaucoma should be considered. Can I place a judgment of glaucoma with a bad result of one visual field examination? What about multiple exams that are not good? A: A bad result on one examination cannot easily lead to a diagnosis of glaucoma. Because there are many factors affecting the visual field examination, it is necessary to repeat the examination if you suspect it. More importantly, it is necessary to combine the fundus, intraocular pressure, atrial angle and medical history to make a comprehensive judgment. Since a variety of diseases can cause changes in the visual field, if multiple visual field examinations are not good, it is also important to exclude some possible other diseases, such as: pituitary tumor, ischemic optic neuropathy, etc., depending on the pattern of visual field damage. Can glaucoma be ruled out if there is no problem with visual field examination? A: Visual field is not the only condition for glaucoma diagnosis. A normal visual field examination cannot rule out glaucoma. Some very early open-angle glaucoma, or early closed-angle glaucoma can be seen without visual field damage. Sometimes the visual field examination will be better than the previous one. Will the visual field “get better” on its own without intervention? If medication has been used, will the visual field gradually recover? A: No, sometimes the visual field test result will be better than the last one. This may be due to the deviation of the test process, for example, the last test was not reliable, but this time the test is more accurate through study, which can be shown as “better”. In fact, the visual field changes caused by glaucoma are irreversible. With effective treatment (medication, laser or surgery), the visual field can be stabilized or slowed down significantly, but it usually does not get better or recover.