Should visual field examination be a routine part of ophthalmic practice?

Visual field screening conducted on indication was compared with routine visual field screening to determine the effectiveness of these strategies in identifying patients with normal and abnormal visual fields. The sample consisted of 1,500 consecutively presenting patients. Each patient was screened with the Friedmann Visual Field Analyser Mark II. Visual field defects were detected in 3.0% of eyes. Routine visual field screening detected a very high proportion of these defects. The two indications approaches which were tested achieved only slightly lower sensitivities and specificities, while necessitating that only approximately 20% of patients required screening. The most effective strategy for screening on indication was based on overall clinical assessment of each case, although the optimal criteria relied on low levels of suspicion.