Dr. Wall's research has two arms. The first is to develop strategies of visual field testing that detect visual field defects at an earlier stage and visual field change at an earlier time. To achieve these goals, we have been studying mechanisms of perimetric variability. We have been funded for this with a VA Merit review for the past 22 years. During this time we have shown that a substantial portion of the variability of perimetry is due to the stimulus size chosen. In the process, we have developed two methods of visual field testing, 1) motion perimetry, that takes advantage of these findings to lower retest variability and 2) software to test the full visual field with the size V stimulus using the Open Perimetry Interface on the Octopus 900 perimeter. The second arm of the research is to study idiopathic intracranial hypertension (pseudotumor cerebri) a disease of overweight women in the childbearing years that causes headache and blindness. Our goal is to find the cause of the disease and to develop evidence-based treatment strategies. We have completed our first clinical trial, funded by the NIH for $16 million over 5 years. The specific aims of the Idiopathic Intracranial Treatment Trial (IIHTT) were 1) determining if diet and acetazolamide is superior to diet alone; 2) with the help of Edwin Stone's laboratory, using a genome wide association study better understand the mechanism of idiopathic intracranial hypertension. We showed that acetazolamide treatment resulted in statistically significant improvements in visual field function, cerebrospinal fluid pressure, papilledema and quality of life. We have been funded for a second trial, the Surgical IIHTT, by the NIH to compare maximal medical therapy with optic nerve sheath surgery and CSF shunting.