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Peripheral Visual Fields

The Cranial Nerve Exam
Peripheral Visual Fields

Overview

  • By identifying loss of vision in a particular field or group of fields, it is possible to localise an intracranial lesion and guide further investigation.
  • The visual fields extend 100 degrees laterally, 60 degrees medially, 60 degrees upward and 75 degrees downward.

    • How to Assess

      • Ask the patient to cover one eye. Slowly move a finger or white examination pin from the upper left, upper right, lower left and then lower right, asking the patient to state when they can see the finger / pin. Repeat with the other eye.

    • Interpretation

    • A
      Unilateral anopia - complete loss of vision in one eyeUnilateral optic nerve lesion or ocular pathology
    • B
      Bitemporal hemianopia - loss of lateral vision in both eyesOptic chiasmal compression
    • C
      Homonymous hemianopia - loss of left or right field in both eyesContralateral optic tract lesion
    • D
      Homonymous inferior quadrantanopia - loss of the left or right lower quarters of vision in both eyesContralateral lower optic radiation lesion
    • E
      Homonymous superior quadrantanopia- loss of the left or right upper quarters of vision in both eyesContralateral upper optic radiation lesion
    • F
      Homonymous hemianopia with macular sparingContralateral occipital lobe lesion
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