Homonymous hemianopsias

11 Jan

Patients often describe visual defect in one eye, but many end up having a homonymous hemianopsia; they just notice it (and thus complain of problems) in the eye on the affected side.

Always do visual field testing on these patients to determine if is present in the other eye (homonymous), which would indicate a stroke.

As the lesion moves back (toward the occipital lobe), the more symmetric the hemianopsia is.

Occipital lobe lesions will be very congruent between both eyes with macular sparing.

Parietal lobe may be a bit less congruent and also have the possibility of hemispatial neglect.

However, an article (link below) found that often the lesion location is not always fully consistent with expectations based on clinical findings (best of luck to you).

 

10-SECOND TAKEAWAY:

Always do visual field testing on patients complaining of unilateral vision loss

if is present in the other eye (homonymous), might indicate a stroke along the visual pathway

Submitted by J. Rothstein.

 

References: http://www.ncbi.nlm.nih.gov/pubmed/16567710; picture 1; picture 2

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