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April 1986

Threshold Amsler Grid Testing: Cross-Polarizing Lenses Enhance Yield

Arch Ophthalmol. 1986;104(4):520-523. doi:10.1001/archopht.1986.01050160076015

• The Amsler grid is a commonly used test for evaluation of the 10° of visual field surrounding fixation. The Amsler grid is a suprathreshold stimulus and thus may not detect relative scotomas. Therefore, we had ten patients with optic neuropathies view the grid through cross-polarizing filters that created low luminance conditions in which the grid was barely perceptible. The patients were also surveyed with a 2-m tangent screen protocol and threshold automated perimetry. The threshold Amsler grid technique increased both the number of defects found and the total area of these defects by approximately a factor of 5. Two thirds of the defects found were confirmed by one of the other screening techniques. Threshold Amsler grid testing is a rapid, inexpensive, and sensitive technique for the evaluation of the central 10° of the visual field.