OBJECTIVES Perimetry in children can be challenging due to low cooperation and short attention span. Especially during the pre-surgical work-up of children with pharmaco-refractory epilepsies, however, diagnosing homonymous visual field defects (HVFDs) can be crucial for planning surgical strategies. Here, we evaluated "campimetry" for visual field testing in children. Furthermore, we analyzed strabismus and anomalous head posture as clinical signs for HVFDs. METHODS Campimetry and a standard orthoptic examination were performed in 18 patients (age range: 3 y 2 m-18 y) who underwent epilepsy surgeries in our center during the study period, and in 11 additional patients (age range: 2 y 10 m-22 y 10 m) with suspected or confirmed HVFDs. RESULTS In 16/18 patients of our unselected surgery cohort, pre- and postoperative campimetry was successfully completed. Of these, only 7/16 patients had intact visual fields pre- and postoperatively, while 5/16 patients already showed preoperative HVFDs and 4/16 patients suffered newly acquired HVFDs as calculated consequences of the surgery. Regarding clinical signs, strabismus (mostly esotropia) and anomalous head posture were specific indicators of HVFDs (strabismus: 6/12 with HVFDs vs 1/18 without; anomalous head posture: 8/12 with HVFDs vs 0/18 without). CONCLUSIONS For perimetry in children with limited cooperation, we suggest campimetry as it allows early detection and fast delineation of HVFDs. This is particularly important in pediatric epilepsy surgery patients, who display a surprisingly high proportion of HVFDs (9/16). Both, strabismus and anomalous head posture can indicate such HVFDs. Therefore, clinicians should pay attention to these clinical signs, especially in the context of epilepsy surgery.

中文翻译：

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发现小儿癫痫手术候选人的同名视野缺损

目标 由于合作能力低和注意力持续时间短，儿童的视野测量可能具有挑战性。然而，尤其是在药物难治性癫痫儿童的术前检查期间，诊断同名视野缺损 (HVFD) 对规划手术策略至关重要。在这里，我们评估了用于儿童视野测试的“campimetry”。此外，我们分析了斜视和异常头部姿势作为 HVFD 的临床症状。方法 研究期间在我们中心接受癫痫手术的 18 名患者（年龄范围：3 岁 2 米-18 岁）和另外 11 名患者（年龄范围：2 岁 10 米- 22 y 10 m) 怀疑或确认 HVFD。结果 在我们未选择的手术队列的 16/18 名患者中，成功完成了术前和术后的campimetry。其中，只有 7/16 的患者在术前和术后具有完整的视野，而 5/16 的患者已经显示出术前 HVFD，4/16 的患者由于手术的计算结果而遭受了新获得的 HVFD。关于临床体征，斜视（主要是内斜视）和异常头部姿势是 HVFD 的具体指标（斜视：6/12 有 HVFD 对比 1/18 没有；异常头部姿势：8/12 有 HVFD 对比 0/18 没有）。结论 对于合作受限的儿童的视野测量，我们建议使用 Campimetry，因为它可以早期检测和快速描绘 HVFD。这对于小儿癫痫手术患者尤其重要，他们的 HVFD 比例惊人地高 (9/16)。斜视和异常的头部姿势都可以表明这种 HVFD。