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The visual pathway consists of structures that carry visual information from the retina to the brain.Lesions in that pathway cause a variety of visual field defects. In the visual system of human eye, the visual information processed by retinal photoreceptor cells travel in the following way:
Visual fields tests will delineate chiasmal syndromes because the missing fields will not cross the midline. Junctional scotomas classically show ipsilateral optic disc neuropathy with contralateral superotemporal defects. Bitemporal hemianopia with or without central scotoma is present if the lesions have affected the body of the chiasm. A ...
Lesions in the pathway cause a variety of visual field defects. The type of field defect can help localize where the lesion is located (see figure). A lesion in the optic nerve of one eye causes partial or complete loss of vision in the same eye, with an intact field of vision in other eye.
Vascular and neoplastic (malignant or benign tumours) lesions from the optic tract, to visual cortex can cause a contralateral homonymous hemianopsia. Injury to the right side of the brain will affect the left visual fields of each eye. The more posterior the cerebral lesion, the more symmetric (congruous) the homonymous hemianopsia will be.
Bitemporal hemianopsia is the medical description of a type of partial blindness where vision is missing in the outer half of both the right and left visual field. It is usually associated with lesions of the optic chiasm, the area where the optic nerves from the right and left eyes cross near the pituitary gland.
If a lesion only exists in one unilateral division of the optic radiation, the consequence is called quadrantanopia, which implies that only the respective superior or inferior quadrant of the visual field is affected. If both divisions on one side of the brain are affected, the result is a contralateral homonymous hemianopsia.
Lesions in the optic tract correspond to visual field loss on the left or right half of the vertical midline, also known as homonymous hemianopsia. A lesion in the left optic tract will cause right-sided homonymous hemianopsia, while a lesion in the right optic tract will cause left-sided homonymous hemianopsia.
Macular sparing can be determined with visual field testing.The macula is defined as an area of approximately + 8 degrees around the center of the visual field. [3] During examination, vision in an area of greater than 3 degrees must be preserved for a patient to be considered to have macular sparing because there is involuntary eye movement within 1 to 2 degrees.