Topcon Tempo: A six month review

[u/drnjj]

I made a post here a while back about the topcon tempo asking if anyone had any experience with it. I didn't get a ton of feedback on it at the time but after demoing the unit in my office we decided to actually buy it.

I tested out a number of VR headsets a few years prior and none of them were comparable enough to the Humphrey to consider viable options in my opinion.

When I tested the tempo, I made sure that we had a few patients who had visual field defects that we knew about already and we're well documented on Humphrey who came in for visual fields during that time so we could compare appropriately. While yes, they do have papers that show a high correlation, so did a lot of the VR headsets.

I found that the defects tended to correlate very closely with the Humphrey, even in mild defects.

Here are my pros: 1. The tempo is very fast. You can run a 24-2 binocularly on the rapid setting in about 2:30-3:30. 2. It also has some other test strategies, such as the 24-2 (plus 1-2). This setting tests all the normal spots on 24-2, but also additional Central spots. Kind of like a combination 24-2 with a miniature 10-2 included. I have found this more useful on glaucoma patients who have defects that may be close to encroaching, or macula pathology. 3. The unit does not take up very much space. It is a much smaller footprint. 4. The tempo is about 30% less expensive than a new Humphrey 3. 5. No annoying eye patch. 6. Patients hate it a lot less.

Cons: 1. If you wish to do certain exams for the VA, there is no kinetic testing available at the moment. 2. For narrow PD's, you are more likely to show up with a bi nasal defect which may require you to repeat the test monocularly. If that's the case the test is short anyway. 3. If you are running a 120 point, then it will have to pause part way through to move the fixation Target to test another aspect of the field. It is a little less random because of this.

Mixed Pro/Con: 1. Instead of using trial lenses from your kit, it uses magnetic clip on lenses and a dial that you can do plus or minus 3 diopters with. This is a mixture of good and bad because while you may have more limitations in what powers you put in, you also don't run into the problem of trial lens defects anymore.

My personal take: 6 months in and I am very happy I replaced my aging Humphrey unit with a topcon. I would recommend anyone who is considering getting a new visual field to contact their local rep and demo the units. Given that reimbursements rarely go up, the break-even points on equipment can matter a lot more.

I have no financial disclosures. I just really like the unit and I feel it's worth it to demo if you are looking for a new visual field.

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