B27. Types of visual field defects
Appearance
Vision is a complex process which involves many neurological structures. Different parts of the vision depends on different structures. As such, a great variety of visual field defects (areas of the visual field with defective or absent vision) can occur depending on which structure is affected.
Homonymous vision loss = same side is lost on both eyes. E. g. temporal half on left eye and nasal half on right eye
Heteronymous vision loss = opposing regions are lost. E. g. temporal half on left eye and temporal half on right eye
Hemianopia = loss of half the vision field
Quadrantanopia = loss of one quarter of the vision field
Types
- Complete unilateral vision loss
- Due to pre-chiasmal lesion (retina or optic nerve)
- Bitemporal heteronymous hemianopia
- = bilateral loss of temporal visual field
- Due to lesion of the middle part of the optic chiasm
- Fibres transmitting the nasal part of the visual field crosses in the optic chiasm
- Fibres transmitting the temporal part of the visual field does not cross
- Ipsilateral nasal hemianopia
- = ipsilateral loss of nasal visual field
- Due to lesion of the lateral part of the optic chiasm
- Binasal heteronymous hemianopia
- = bilateral loss of nasal visual field
- Due to lesion of both lateral parts of the optic chiasm
- Contralateral homonymous hemianopia
- = loss of the ipsilateral nasal and contralateral temporal visual fields
- Due to lesion of the optic tract
- The optic tract transmits information from the ipsilateral nasal visual field and the contralateral temporal visual field
- Contralateral homonymous upper quadrantanopia
- = loss of ipsilateral upper nasal quadrant and contralateral upper temporal quadrant
- Due to lesion of
- Anterior part of optic radiation
- Lower part of calcarine fissure
- Contralateral homonymous lower quadrantanopia
- = loss of ipsilateral lower nasal quadrant and contralateral lower temporal quadrant
- Due to lesion of
- Posterior part of optic radiation
- Upper part of calcarine fissure
- Contralateral homonymous hemianopia with central sparing
- = loss of the ipsilateral nasal and contralateral temporal visual fields, but the central vision remains intact
- Due to lesion of the occipital lobe