Short-wavelength automated perimetry without lens density testing.

Three experiments determined whether an estimate of localized short-wavelength visual field loss could provide enough specificity and sensitivity for glaucoma diagnosis, without correcting the fields for lens density. We used 100 normal, 53 glaucoma suspect, and 95 glaucoma eyes (or a subset of these, where noted). The first two experiments showed that lens density has a diffuse effect on the visual field, which is more linear than the effect of age. The third experiment showed that, with the glaucoma hemifield test, comparable results were obtained for short-wavelength fields either corrected or uncorrected for lens density (sensitivities of 81% and 76% and specificities of 82% and 90%, respectively). We conclude that it is possible to eliminate the lens density measurement with this approach, thereby reducing test time by 40 minutes. This should improve substantially the clinical utility of short-wavelength automated perimetry.