Language of instruction and the effect on visual field results

Automated perimetry, a psychophysical test, requires meticulous cooperation of the tested patient. Immigrant populations who do not speak the local language may have poorer performance. This study evaluates this effect. Materials and Methods: The study was conducted in Israel where the dominant language is Hebrew. A total of 49 non-Hebrew speaking patients comprised the study group. The controls numbered 173 matched for age and gender. The examinations were conducted within the same 2 month period and by the same group of technicians. The groups were compared for clinical reliability score (RS), percent of fixation loss and a visual field damage score (VFDS). The RS and VFDS increased with poorer reliability or increasing damage. Hebrew speakers were uniformly instructed by the perimetry technician. Non-Hebrew speakers were instructed by technicians (N=34), or non professionals (accompanying person) N=15. Results: The mean age of the entire group was 69.7 13.1 □ years. The mean age of the study group was 67.1 18.0□years. The patients in the study group spoke seven different foreign languages. The reliability scores, percent fixation loss and VF damage scores did not differ significantly between the Hebrew and non-Hebrew speaking group. The subgroup of non-Hebrew speakers instructed by nonprofessionals had significantly poorer indices of reliability and higher VF damage scores. Conclusions: Proper instruction is critical for quality results in perimetry. The study indicated that immigrants would not be handicapped in their performance when given professional instruction in their own language.