The detection of both global motion and global form is disrupted in glaucoma.

PURPOSE It is well known that glaucoma results in performance impairments on tasks processed early in the visual pathways. Glaucoma should also impair cortical visual processing because of reduced input from retinal ganglion cells and also possibly because of abnormal cortical function. This study was undertaken to assess whether cortically processed global percepts are disrupted in glaucoma in areas of visual field classified as normal by standard automated perimetry (SAP). Performance on global tasks (motion and form) was compared to measures of presumed precortical magnocellular and parvocellular function in the same individuals. METHODS Fifteen control subjects and 12 patients with primary open-angle glaucoma participated. Testing was performed foveally and midperipherally (12.5 degrees). Contrast-discrimination thresholds were measured by using the steady-pedestal (magnocellular) and pulsed-pedestal (parvocellular) contrast-discrimination tasks of Pokorny and Smith. Global motion coherence and global form coherence thresholds were measured at high and low contrast. RESULTS Patients with glaucoma demonstrated higher global motion and form-coherence thresholds than did control subjects for targets presented in the midperiphery (P < 0.05), but not foveally. Different individuals performed poorly on the motion and form tasks. The subjects with the greatest presumed magnocellular and parvocellular loss were those with the largest deficits on the global motion and form tasks, respectively. CONCLUSIONS Some subjects with glaucoma demonstrate profound impairments of global motion or global form integration in areas of visual field classified as normal by SAP. This finding implies that some people with glaucoma may have far greater difficulty with complex visual tasks (for example, navigation through the environment or face recognition) than is predicted by their visual field loss.