Pupillary anomaly masquerading as a glaucomatous visual field defect: a case report

BACKGROUND: Patients are often referred to ophthalmologists with focal visual field defects on routine testing, possibly related to a potential diagnosis of glaucoma. However, examination of the individual patient's ocular characteristics as well as facial characteristics may often reveal a cause of the visual field defect. CASE PRESENTATION: We describe a patient who was found to have a superior visual field defect on routine testing by the optician. Repeat perimetry with pharmacological dilatation of the pupil revealed that the cause of the field defect was related to an eccentric inferiorly displaced pupil, secondary to trauma some years previously. DISCUSSION: Individual patient characteristics, including both ocular, as well as facial, need to be considered, when interpreting any visual field defect.