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Preliminary testingOptometric Technician

Confrontation visual fields

Screen both visual fields by finger counting, recognize the classic defect patterns, and know which findings stop the workup.

Competent means: Tests all four quadrants of both eyes with valid technique, names the defect pattern, and triages sudden-onset defects to the doctor immediately.

Three ways through this module

Same cases, three depths. Onboard once, drill whenever there's a gap in the schedule, and certify when you can hold the standard without coaching.

Onboarding

Teaches the procedure from zero, then walks every case with coaching. For a new hire's first week.

Length
~50 min
Cases
4
Pass mark
70%
Pace target
18m 0s

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Drill

One case, graded immediately. Short enough to run in the gaps between patients.

Length
~8 min
Cases
1
Pass mark
80%
Pace target
4m 30s

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Certification

Three cases, no coaching, no feedback until the end. This is what signs someone off.

Length
~19 min
Cases
3
Pass mark
85%
Pace target
13m 30s

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Watch it done

Shown once during onboarding

Confrontation fields, start to finish

Footage not filmed yet

One uninterrupted screening on a real patient, so the geometry stops being abstract: how far apart you actually sit, what mirroring the eyes looks like from behind the examiner, and how a patient behaves when a quadrant is genuinely missing.

Shot list

target 4m 0s

  1. 0:00Wide shot of the lane: examiner and patient seated facing each other at arm's length, eyes level, room lights up. Hold long enough to read the distance.
  2. 0:20Over the patient's shoulder — the full instruction, spoken at normal pace and audible. This is the shot technicians will copy verbatim.
  3. 0:50Close on the occlusion: patient's palm cupped over the left eye without pressing, examiner closing their own right eye. Show both at once.
  4. 1:10Present in all four quadrants of the right eye, midway between the two faces. Keep the examiner's fixating eye in frame — the point is that they watch the patient, not their own hand.
  5. 2:10Repeat on the left eye at normal working speed, uncut, so the run reads as ninety seconds rather than a sequence of poses.
  6. 3:00A patient who misses a quadrant: the pause, the guess, and the moment they say they see nothing. Real hesitation, not acted.
  7. 3:30Charting the result on screen, and the handover sentence spoken aloud to the doctor.

Drop the files in public/demos/ as confrontation-fields.mp4, .webm, .jpg poster and .vtt captions, then set this module's demo.status to ready.

What this module trains

  • Set up and instruct the patient for confrontation testing
  • Occlude and mirror the correct eyes
  • Cover all four quadrants of each eye
  • Recognize bitemporal, homonymous and altitudinal patterns
  • Escalate sudden-onset field loss the same day

The lesson, in onboarding

~7 min of reading

Ninety seconds of finger counting is the only visual field test most patients will ever get. Here's what it's actually looking for, and why the technique is so unforgiving.

  1. 1Why this test earns its ninety seconds
  2. 2The visual pathway, in one page
  3. 3Read the defect against the midlines
  4. 4Your own visual field is the instrument
  5. 5The four ways this test quietly fails
  6. 6What you do when you find something

How a case runs

  1. 1Meet your patientbriefing
  2. 2Call it before you testclinical accuracy · 5 pts
  3. 3Position yourselftechnique · 10 pts
  4. 4Instruct the patientpatient communication · 10 pts
  5. 5Mirror the eyestechnique · 10 pts
  6. 6Run the testtechnique · 25 pts
  7. 7Name the patternclinical accuracy · 10 pts
  8. 8Localize itclinical accuracy · 10 pts
  9. 9Chart and triageclinical accuracy · 10 pts
  10. 10Paceefficiency · 10 pts, graded on hands-on time

How it's graded

Technique45 pts
Did the test itself get done correctly?
Patient communication10 pts
Did the patient know what to do, and feel able to report the truth?
Clinical accuracy35 pts
Was the finding named, charted and localized correctly?
Efficiency10 pts
Could this be done at lane pace once technique is clean?

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Case rotation

Cases are dealt at random, and a retake avoids the ones you just saw. The finding stays hidden until you have worked it out, so repeating a module is practice rather than recall.

  • Case 1 — 34Fcore
  • Case 2 — 47Mintermediate
  • Case 3 — 68Fadvanced
  • Case 4 — 71Madvanced

Want a specific case for teaching? Append &case=ftfc to the simulator URL.