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Signs
 
 

Peripheral Visual Fields

 
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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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