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. 2017 Jul 3;6(4):3.
doi: 10.1167/tvst.6.4.3. eCollection 2017 Jul.

Pediatric Perimeter-A Novel Device to Measure Visual Fields in Infants and Patients with Special Needs

PremNandhini Satgunam  1   2 , Sourav Datta  1 , Koteswararao Chillakala  2 , Karthik R Bobbili  2   3 , Dhruv Joshi  2   4
Affiliations

Pediatric Perimeter-A Novel Device to Measure Visual Fields in Infants and Patients with Special Needs

PremNandhini Satgunam et al. Transl Vis Sci Technol. .

Abstract

Purpose: There are no commercially available devices to measure visual fields in infants. We developed a device, "Pediatric Perimeter," that quantifies visual field extent (VFE) for infants. We describe the construction, validation, and use of this device.

Methods: A hemispherical dome with light emitting diodes (LEDs) was constructed. The LEDs were controlled using a computer program to measure reaction time (RT) to gross visual fields (GVF) and the VFE. Participants were tested in supine position in a dark room. Eye or head movement towards the stimuli was monitored with an infrared (IR) camera. Validation was done on 10 adults (mean age: 24.4 ± 5 years) with tunnel vision simulator.

Results: Perimetry was performed on 19 infants (age: 2.3-12 months), five infants with normal milestones. GVF and VFE were estimated in 17 and 7 infants, respectively. Median RT of infants with developmental delay was 663 ms and 380 ms for healthy infants. Also, 14 children (age: 14 months-6 years) with developmental delay and five patients with cognitive impairment were tested.

Conclusion: Visual field isopter and RT can be examined with the Pediatric Perimeter device on infants and patients with special needs. Further testing on infants will need to assess the repeatability. A large-scale study will be needed to compare typically developing infants and infants with delayed milestones with this device.

Translational relevance: Quantifiable parameters obtained with this device can be used as outcome measures in clinical examination of infants and patients with special needs. This device can be used in pediatric, neurology, and ophthalmology clinics.

Keywords: cognitive impairment; infants; perimetry; special needs; visual fields.

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Figures

Figure 1
Figure 1
Schematic diagram of the Pediatric Perimeter device (prototype III), showing the skeletal structure of the hemispherical dome. The magnified screen snapshot of an infant getting tested and the GUI is also shown. Informed consent has been obtained from parents to publish the image of the infant.
Figure 2
Figure 2
Illustration of video frame analysis with Datavyu software. (a) Infant fixating straight. (b) Quadrant stimuli (yellow) are presented. (c) Infant initiating an eye movement toward the stimuli. (d) Infant completing the fixation gaze (eye and head movement) toward the stimuli. Examiner registers the response (color change to green). Time difference between (b) and (c) is used to calculate reaction time. Informed consent has been obtained from parents to publish the image of the infant.
Figure 3
Figure 3
Scatter plot showing the visual field radius of 10 participants with the tunnel vision simulator. The expected visual field radius (16°) is marked as a solid line.
Figure 4
Figure 4
Visual field isopters obtained with the Pediatric Perimeter and HVF device on three patients. The radial spacing of the circles are 15° and 10° in the Pediatric Perimeter and HVF, respectively.
Figure 5
Figure 5
Visual field isopters obtained from the Pediatric Perimeter device on three participants.
See this image and copyright information in PMC

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