Review of portable visual field devices shows higher patient preference over table-mounted analyzers in rural glaucoma care.

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medRxiv Published April 26, 2026 Medically reviewed April 26, 2026 Study authors: Antwi-Adjei, E. K.; Datta, S.; Girkin, C. A.; Owsley, C.; Rhodes, L. A.; Fifolt, M.; Racette, L. DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider portable perimetry for telemedicine glaucoma monitoring in resource-limited settings based on patient preference data.

This mixed methods review examined patient preferences for future visual field testing among 271 respondents across three Federally Qualified Health Centers in Alabama. The study compared portable visual field devices, including tablet-based Melbourne Rapid Fields and virtual reality-based VisuALL perimeters, against a table-mounted Humphrey Field Analyzer within the AL-SIGHT study setting.

Key findings demonstrate that 50.6% of respondents preferred VR-based testing, compared to 35.1% for tablet-based and 14.4% for table-mounted devices (Cramers V = 0.31, p<0.001). Satisfaction scores followed a similar trend, with 56.9% very satisfied with VR-based testing versus 49.4% for tablet-based and 38.0% for HFA. Additionally, the VR-based perimeter was selected as the most comfortable device by 55.7% of participants (V = 0.34, p<0.001) and the easiest to use by 54.6% (V = 0.36, p<0.001).

The authors observed that preferences did not vary significantly across demographic variables (all p>0.05). Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. The review concludes that portable perimetry may enhance patient-centered glaucoma monitoring within telemedicine programs and access in resource-limited settings, though clinical outcomes were not evaluated.

Study Details

EvidenceLevel 5

PublishedApr 2026

View Original Abstract ↓

Purpose To evaluate patient satisfaction and preferences for portable versus table-mounted visual field (VF) devices in a rural telemedicine setting and identify influencing factors. Methods We conducted a sequential explanatory mixed methods study at three Federally Qualified Health Centers (FQHCs) within the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) study. Participants completed VF testing with table-mounted Humphrey Field Analyzer (HFA), tablet-based Melbourne Rapid Fields (MRF), and virtual reality (VR)-based VisuALL perimeters. Participants rated satisfaction, comfort, ease of use, and future testing preference. Chi-square tests assessed differences in device preferences. Twelve participants completed semi-structured interviews to explore reasons underlying preferences. Qualitative data were analyzed in NVivo 14 using reflexive thematic analysis. Results Among 271 respondents (mean age 60.4 years; 62.4% women), 50.6% preferred VR-based, 35.1% tablet-based, and 14.4% table-mounted for future testing ({chi}2 (2) = 53.52, p<0.001, Cramers V = 0.31). Satisfaction was highest for VR-based (56.9% very satisfied), followed by tablet-based (49.4%), and HFA (38.0%). VR-based perimeter was most frequently selected as the most comfortable (55.7%; {chi}2 (2) = 63.33, p<0.001, V = 0.34) and easiest to use (54.6%; {chi}2 (2) = 71.96, p<0.001, V = 0.36). Preferences did not vary significantly across demographic variables (all p>0.05). Qualitative themes identified four key drivers: comfort and physical experience, visual experience, ease of use and interaction, and psychological and motivational factors. Portability and community suitability were valued. Conclusion Rural underserved patients strongly preferred portable visual field devices, particularly VR-based, over table-mounted HFA. Comfort, ergonomic flexibility, immersive visual experience, and simplicity of interaction were central determinants of preference. Portable perimetry may enhance patient-centered glaucoma monitoring within telemedicine programs and access in resource-limited settings.