Ophthalmology Research: An International Journal

Kinetic perimetry, in which a moving stimulus of fixed luminance and size is advanced from a non-seeing towards a seeing region to define an isopter, was the dominant method of visual field assessment for several decades before static threshold perimetry displaced it from routine practice. Its position in modern ophthalmology is unsettled. Manual instruments are increasingly scarce, the examiner-dependent technique is difficult to standardise, and quantitative analysis remains awkward, yet kinetic testing continues to be requested for advanced field loss, peripheral disease, paediatric assessment, neuro-ophthalmic localisation, oculoplastic documentation and disability certification, and it supplies endpoints in trials of gene-directed therapy for inherited retinal disease. This critical narrative review examines what the accessible evidence can and cannot support about that continuing role. Literature was identified through PubMed and Crossref Metadata Search for the period from January 1980 to 30 May 2026, supplemented by reference-list examination, and appraised for design adequacy, sample composition, measurement validity and analytical robustness rather than tabulated study by study. Four findings emerge with reasonable confidence: semi-automated kinetic perimetry reproduces Goldmann isopters closely for large, bright targets but diverges for smaller targets and for instruments with restricted bowl geometry; test-retest variability is acceptable for high-contrast isopters in experienced hands yet deteriorates sharply for dim targets, small residual fields and inexperienced observers; reaction-time handling is a principal and under-standardised determinant of isopter position; and statokinetic dissociation, long interpreted as a physiological or pathological signal, is largely abolished when static and kinetic psychophysical procedures are equated, which reframes it as a methodological artefact of criterion bias. Substantial uncertainty persists regarding longitudinal responsiveness, paediatric interpretability, normative reference limits and the equivalence of emerging virtual-reality implementations. Kinetic perimetry retains defensible, circumscribed indications, but its quantitative use as a progression or trial endpoint currently rests on a narrower evidentiary base than its clinical familiarity implies.