A novel paediatric game-based visual-fields assessor

Aim: To determine the feasibility of using a computer game to measure visual fields in children. Methods: The authors describe the development and assessment of a novel computer-game apparatus to measure visual fields in children. It is based upon a computer game visible on a monitor, housed in an interactive model-castle structure. Results: The authors conducted a total of 25 field tests with the final apparatus, in 25 eyes of 19 children, aged 4-14 years. On two occasions children failed to complete the exam, owing to hardware and software defects that were subsequently rectified. For the 23 completed fields, the median time for completion of the full test was 4.5 min. 16 out of 18 clinically normal patients showed normal fields; the only failures were in two 4-year-old children who still managed to complete fields, but with generalised reduced responses that were deemed abnormal by our predetermined criteria. For the five eyes with expected glaucomatous loss, all five visual fields measured were completed and showed abnormal fields consistent with their medical condition. Positive feedback was given from all children about their testing experience. Conclusions: It is feasible to develop a computer-game-based system to measure fields in children in a noninvasive, affordable and entertaining way.