On Humphrey visual field testing using SITA-Standard 24-2 program, a patient shows a pattern deviation plot with a cluster of 3 adjacent points with p<1% depression in the superior nasal arcuate region, and the glaucoma hemifield test result is 'outside normal limits.' The most appropriate next step is:

• A Repeat the test immediately as artifact is likely
• B Repeat the field test after 4–6 weeks to confirm reproducibility ✓
• C Diagnose early glaucoma and start treatment
• D Order MRI brain to rule out intracranial pathology

Explanation

A single visual field test showing a suspicious defect requires confirmation by a repeat test (typically 4–6 weeks later) before diagnosing glaucoma, because false positives from learning effect, fatigue, and media opacities are common. The Anderson criteria require reproducible defect on at least two reliable fields. Immediate treatment without confirmation is premature; MRI is warranted when non-glaucomatous patterns (e.g., respecting vertical midline) are suspected.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.