48 Questions
What type of visual field defect is seen in a lesion to the center of the chiasm?
Bitemporal hemianopsia
Which of the following lesions causes a central VFD in one eye and a partial temporal VFD in the opposite eye?
Lesion to the proximal fibers of an ON and the nasal fibers of the opposite eye
What is the term for a visual field defect that affects one side of the visual field in both eyes?
Homonymous hemianopsia
Which lobe is associated with an inferior quadrantanopsia?
Parietal lobe
What type of lesion causes a homonymous hemianopsia?
Lesion to the optic radiations
What is the term for a visual field defect that affects the upper quadrant of the visual field?
Superior quadrantanopsia
Which condition is associated with a central VFD?
Optic neuritis
What type of lesion causes a bitemporal hemianopsia?
Chiasm lesion
Which condition is associated with an altitudinal VFD?
Anterior ischemic optic neuropathy (AION)
What type of lesion causes a junctional scotoma?
Lesion to the proximal fibers of an ON and the nasal fibers of the opposite eye
What is the normal range of a single eye's visual field in degrees?
130-145 degrees
Where is the physiological blind spot located in relation to the eye being evaluated?
15 degrees temporal and 5 degrees inferior from central fixation
What is the primary function of the central visual field?
Color vision and details
What is the range of the temporal visual field in degrees?
100-110 degrees
What is the term for the loss or defect of the visual field that may be the only sign of a lesion in the visual pathway?
Visual field defect
What is the primary function of the peripheral visual field?
Detection of motion signals
What is the range of the nasal visual field in degrees?
60 degrees
What is the term for the type of visual field defect that occurs when there is a lesion in the optic nerve?
Central scotoma
What is the range of the superior visual field in degrees?
50-60 degrees
What is the term for the type of visual field defect that occurs when there is a lesion in the chiasm?
Bitemporal hemianopsia
What type of visual field defect is associated with optic nerve lesions?
Monocular ipsilateral defect
What is the common cause of a right complete homonymous hemianopsia?
A stroke in the left side of the brain
What type of visual field defect is often associated with pituitary gland tumors?
Bitemporal hemianopsia
What is the characteristic of a pre-chiasmal altitudinal defect?
It respects the horizontal meridian
What type of lesion would cause a visual field defect in the left side of both eyes?
Post-chiasmal lesion in the left side of the brain
What type of visual field defect is characterized by a loss of half of the visual field in one eye?
Monocular hemianopsia
What is the term for a visual field defect that affects the same half of the visual field in both eyes?
Homonymous hemianopsia
What type of lesion is typically associated with a bitemporal hemianopsia?
Chiasm lesion
What is the term for a circular area of depressed vision surrounding the point of fixation?
Annular scotoma
What is the term for a visual field defect that affects the peripheral vision?
Peripheral scotoma
What is the primary function of the peripheral visual field?
Detection of motion signals
What is the location of the physiological blind spot in relation to the eye being evaluated?
15 degrees temporal and 5 degrees inferior from central fixation
What is the range of the temporal visual field in degrees?
100-110 degrees
What is the primary function of the central visual field?
Recognition of detailed vision and color vision
What is the range of the inferior visual field in degrees?
60-80 degrees
What type of visual field defect is often associated with lesions to the proximal fibers of an optic nerve and the nasal fibers of the opposite eye?
Junctional scotoma
What type of lesion causes a homonymous hemianopsia?
Lesion to the optic tract
What type of visual field defect is seen in patients with retinitis pigmentosa?
Peripheral VFD
What type of lesion causes an inferior quadrantanopsia?
Lesion to the parietal lobe
What type of visual field defect is seen in patients with anterior ischemic optic neuropathy (AION)?
Altitudinal VFD
What type of visual field defect is seen in patients with strokes (CVA) or traumatic brain injury (TBI)?
Any of the above
What is the purpose of confrontation visual fields (CVF) and finger counting fields (FCF)?
To evaluate the extent of visual field defects
What is the term for a visual field defect that affects the same half of the visual field in both eyes?
Homonymous hemianopia
What is the characteristic of a post-chiasmal altitudinal defect?
Respects the vertical meridian
What is the term for a circular area of depressed vision surrounding the point of fixation?
Annular scotoma
What is the term for a visual field defect that affects the upper quadrant of the visual field?
Superior altitudinal defect
What is the characteristic of a congruous visual field defect?
The same size and shape in both eyes
What type of visual field defect is often associated with glaucoma?
Depression or constriction
Study Notes
Visual Field Defects
- A lesion in the visual pathway can cause visual field defects (VFDs) which can be classified into different types based on their location and shape.
Types of Visual Field Defects
- Central VFD: a defect in the central 30 degrees of vision, often seen in optic neuritis, macular hole, cone dystrophy, BRAO, and BRVO.
- Peripheral VFD: a defect in the peripheral vision, often seen in retinitis pigmentosa, BRVO, BRAO, hysterical amblyopia, and Streff Syndrome.
- Hemianopia: a defect in half of the visual field, often seen in strokes (CVA), traumatic brain injury (TBI), and intracranial mass.
- Quadrantanopia: a defect in a quarter of the visual field, often seen in strokes (CVA), traumatic brain injury (TBI), and intracranial mass.
- Altitudinal VFD: a defect above or below the horizontal meridian, often seen in anterior ischemic optic neuropathy (AION), compressive neuropathy, BRAO, BRVO, papilledema, and disc edema.
Visual Pathway Lesions
- Lesions in the visual pathway can cause different types of VFDs:
- Pre-chiasmal lesions: monocular ipsilateral defect (e.g., macular hole, retinal detachments, glaucomatous changes, optic atrophy, or optic neuropathy).
- Chiasmal lesions: bitemporal hemianopsia (e.g., tumor compressing pituitary gland or aneurysm of the anterior communicating artery).
- Post-chiasmal lesions: homonymous hemianopsia (e.g., stroke, traumatic brain injury, or intracranial mass).
Visual Field Evaluation
- Confrontation Visual Fields (CVF) and Finger Counting Fields (FCF) are methods used to evaluate the visual field.
- Automated perimetry and tangent screens are more detailed methods used to evaluate the visual field.
- Visual field defects can be categorized as congruous (symmetric) or incongruous (asymmetric).
Terminology
- Depression/Constriction: a general reduction in overall sensitivity of the visual field.
- Scotoma: an area of depressed vision surrounded by an area of less depressed or normal vision.
- Shallow or Relative Scotoma: an area of the retina that is not sensitive to relatively dim stimuli but is sensitive to brighter/lighter stimuli.
- Deep or Absolute Scotoma: no response to a stimulus regardless of brightness or size.
This quiz covers the effects of lesions on the optic nerve and optic radiations on visual field defects. Learn about the different types of visual field defects caused by lesions in different parts of the optic pathway. Test your knowledge of optic nerve lesions and visual field defects.
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