Certified Ophthalmic Medical Technologist (COMT) Practice Exam

Which visual field defects may be seen in early glaucoma?

1. Isolated paracentral, nasal step, and temporal wedge defect

2. Complete peripheral loss, tunnel vision, and macular edema

3. Foveal sparing, central scotoma, and color vision deficiency

4. Arcuate, peripheral, and double vision

The correct answer is: Isolated paracentral, nasal step, and temporal wedge defect

In the context of early glaucoma, the visual field defects that may be observed include isolated paracentral defects, nasal steps, and temporal wedge defects. These specific types of visual field loss are characteristic of glaucoma because they reflect the pattern of neural damage that typically begins in the optic nerve head and progresses over time. Isolated paracentral scotomas are small areas of vision loss located near the center of the visual field, while nasal steps signify a gradation of vision loss that occurs in a step-like pattern towards the nasal side. Temporal wedge defects refer to the loss of vision that occurs in a wedge shape, extending from the edge of the visual field inward. These defects are due to the degeneration of ganglion cells in specific areas of the retina, correlating well with the increased intraocular pressure associated with glaucoma. Other answer choices include visual field defects that are either not associated with early glaucoma or represent more advanced stages of vision loss. For instance, complete peripheral loss and tunnel vision are indicative of more severe glaucoma, and macular edema is unrelated to typical glaucoma presentations. Foveal sparing and central scotoma are more characteristic of diseases affecting the macula rather than changes seen in glaucoma. Lastly, double vision is not a typical