Test Visual Fields

By: Carmen Willings   
teachingvisuallyimpaired.com
Updated June 14, 2025
The visual field refers to the total area that can be seen without moving the eyes or head. As part of a Functional Vision Evaluation (FVE), assessing a student's visual fields is critical, even if clinical eye reports do not indicate any deficits. Many ophthalmologists and optometrists do not formally assess visual fields in young children due to the student's age or limited cooperation.
Typical visual field ranges from the center of gaze are:
  • 60 degrees nasally (toward the nose)
  • 90 degrees temporally (toward the ears)
  • 50 degrees superiorly (above center)
  • 70 degrees inferiorly (below center)

Methods of Visual Field Assessment

Observation
Often, the most effective and natural way to identify field restrictions is. Look for behaviors that suggest difficulty detecting objects in specific areas of the visual field.
Confrontation Field Testing (Informal)
This is a simple and quick method to estimate field limitations:
  • Position the student directly across from the examiner.
  • Ask the student to fixate on the examiner’s nose.
  • Slowly bring a brightly colored or high-contrast object from behind the student’s head into view in various arcs (temporal, nasal, superior, inferior).
  • The student should indicate when they first detect the object.
  • Repeat this process in all quadrants.

Functional Implications of Visual Field Loss

  • Central Vision (the “what” system): used for recognizing faces, reading, and fine detail tasks.
  • Peripheral Vision (the “where” system): used for spatial awareness, navigation, and movement detection.
Signs of Possible Visual Field Deficits
  • Holding materials off to the side, up, or down
  • Turning the head consistently to one side (eccentric viewing)
  • Missing items on one side of a page
  • Over-scanning or repeatedly scanning visual arrays
  • Stumbling over low-lying obstacles or curbs
  • Difficulty descending stairs
  • Reduced reading efficiency due to limited print span
  • Distractibility caused by overreliance on peripheral vision
  • Missing people or gestures outside of central vision, potentially leading to social challenges
Assessment Clues
  • Compensatory behaviors such as:
    • Head turns suggest peripheral loss on the opposite side.
    • Inconsistent scanning on tasks like maps or word searches, especially when the head is kept still, may reveal scotomas.
  • Eye preference or consistent use of one eye may indicate a unilateral field deficit.
  • Navigation behaviors (indoors/outdoors; familiar/unfamiliar environments) can provide insights into how the student compensates for field loss.
  • Document the use of corrective lenses and whether the student tolerates them.
  • Indicate whether the student receives or has received Orientation & Mobility (O&M) instruction.

Impact on Function

A restricted peripheral field (less than 180 degrees) may:
  • Impair social interaction due to not noticing people approaching
  • Increase risk during physical activities or ball games
  • Hinder navigation of stairs or curbs
  • Limit reading efficiency (fewer letters/words visible at once)
  • Result in unusual posture for better visual access

​Recommendations & Strategies

Based on the student’s visual field findings, consider the following supports:
  • Seat the student on the left, center, or right side of the classroom based on their strongest field of vision.
  • Use caution during physical education or recess involving fast-moving objects.
  • Train the student to scan the environment before moving into new or busy areas.
  • Refer for an Orientation & Mobility (O&M) evaluation if not already in place.
  • Encourage systematic search techniques during near and far visual tasks.
  • Minimize environmental clutter, especially in high-traffic areas.
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