How did your training under Herschel Leibowitz, PhD, influence you?
Dr. Leibowitz had a strong interest in applying basic laboratory findings to real-world problems, and his students (me included) were strongly affected by his goal. We ventured into a variety of applied areas, including human factors, instrument design, aviation and traffic safety, hypnosis, sources of experimental bias, and the like. I chose ophthalmic research and became involved in the development of diagnostic tests and the evaluation of ocular and neurologic diseases such as glaucoma. I also maintain an interest, however, in the visual requirements for different occupations, traffic and aviation safety, and related areas. Dr. Leibowitz provided me with the ability to see the big picture and the practical value of research as opposed to specific details that have a modest impact on society and are of interest to only a few other academicians.

How did you become interested in the psychophysics of visual fields?
Visual field testing was quite a mystery to me when I was first introduced to it in 1975. During my initial work in this area, however, I also realized that most of the psychophysical principles employed were between 100 and 150 years old. It occurred to me that the proper application of more recent psychophysical procedures and the incorporation of more recent knowledge of basic ophthalmic, neurologic, and neurophysiologic findings would improve the utility of this diagnostic procedure. Today, many new approaches to visual field testing, new sensitivity estimation procedures, and a number of techniques for statistical and mathematical analysis have been incorporated into visual field testing procedures—all within an automated framework that is being used worldwide. If anything, my interest in the psychophysics of visual fields has increased rather than diminished.

What is the best way in which to tailor the visual field to match a patient's needs?
Perhaps the most important aspect of visual field testing is being able to select a testing method that provides the most useful and meaningful clinical information. A key component of this process is constructive interaction between the clinical practitioner, the visual field examiner, and the patient. A dynamic, flexible, and interactive approach is needed. For example, patients with severe disease or multiple medical conditions, young children, and adults with limited attention spans and cognitive skills require a different type of testing procedure than a typical highly functioning and conscientious patient. I do not believe that one size fits all when it comes to visual field testing. The procedure of choice requires good listening skills on the part of the examiner.

What will visual field testing be like in 10 years?
Throughout my career, I have been unable to accurately predict what I would be doing from a research standpoint 10 or even 5 years hence, although it has seemed to work out well most of the time. I believe that predicting the future of new diagnostic procedures and treatments represents a similar challenge. Serendipity is a part of medical research, as are the paradigm shifts that have been described by Thomas Kuhn.1 Visual field testing has reached a saturation point, and a new paradigm is needed. Although the specific answer is still uncertain, I feel that clinical investigators will develop visual field testing procedures that are more objective, efficient, accurate, precise, and diagnostic. I further expect that these procedures will be meaningfully different from those that are currently available. Techniques that can simultaneously capture multiple features (structure, function, metabolism, neuroprotection, and other factors) would represent a major advance.

You are rumored to have played the piano for a living while in school and are said to have perfect pitch. What place does music hold in your life, and has it helped your career?
Music continues to be an important part of my life, and I am still playing on a solo basis, in a rock band, and in a jazz band. Like research, music has a certain structure, but it also provides an opportunity for me to be creative.

By the time I was halfway through my college training, all laboratory experiments had predetermined outcomes, and a person reached either a correct or an incorrect answer. At that point, I took a laboratory course in visual perception, and the projects had controversial and uncertain solutions. This intrigued me and has remained my primary reason for conducting ophthalmic research. A transition from classical piano training to jazz and rock and roll improvisations was a similar experience for me. Evaluating perfect pitch in music and assessing the diagnosis and treatment of glaucoma provide me with many challenges and opportunities, and I consider them both with enthusiasm.

  1. Kuhn TS. The Structure of Scientific Revolutions. Chicago, IL: University of Chicago Press; 1962.