Visual field defects

Anatomical Classification of Visual Field Defects

1. Homonymous Hemianopia

Loss of vision in the same half of the visual field for both eyes

Subtypes:

a) Right Homonymous Hemianopia

b) Left Homonymous Hemianopia

c) Homonymous Hemianopia with Macular Sparing

Common Causes:

Stroke, brain tumor, traumatic brain injury

2. Bitemporal Hemianopia

Vision loss in the temporal fields of both eyes

Primary Causes:

- Pituitary tumors

- Optic chiasm compression

- Bilateral optic nerve pathology

3. Altitudinal Visual Field Defect

Horizontal field loss (upper or lower half)

Types:

a) Superior Altitudinal Defect

b) Inferior Altitudinal Defect

Associated Conditions:

- Anterior ischemic optic neuropathy

- Glaucoma

- Retinal artery occlusion

4. Quadrantanopia

Loss of vision in one quarter of the visual field

Subtypes:

a) Superior Quadrantanopia

b) Inferior Quadrantanopia

c) Right-sided Quadrantanopia

d) Left-sided Quadrantanopia

Common Causes:

- Optic radiation damage

- Cortical lesions

- Stroke

5. Central Scotoma

Complete or partial loss of central vision

Characteristics:

- Affects fixation point

- Significant impact on visual acuity

Associated Conditions:

- Macular degeneration

- Optic neuritis

- Diabetic retinopathy

6. Peripheral Field Constriction

Gradual narrowing of the visual field

Types:

a) Concentric Constriction

b) Sectoral Constriction

Causes:

- Retinitis pigmentosa

- Glaucoma

- Neurological disorders

7. Arcuate Scotoma

Curved or bow-shaped visual field defect

Primary Association:

- Glaucomatous damage

- Optic nerve pathology

Characteristics:

- Often follows retinal nerve fiber layer distribution

- Typically respects horizontal meridian

8. Nasal Step Defect

-Asymmetric loss along the nasal side of visual field

Typical Cause:

- Early-stage glaucoma

- Optic nerve damage

9. Tunnel Vision

Severe peripheral field loss

Characteristics:

- Narrow central vision preserved

- Significant functional impairment

Associated Conditions:

- Advanced glaucoma

- Retinitis pigmentosa

- Chronic retinal diseases

10. Junctional Scotoma

Unique defect involving one eye's nasal field and the opposite eye's temporal field

Primary Cause:

- Lesions near the optic chiasm

- Specific neurological pathologies

Clinical Significance

Diagnostic Considerations

- Precise mapping of defect boundaries

- Correlation with anatomical lesion location

- Comprehensive neurological evaluation

- Advanced imaging correlation

Management Approaches

1. Diagnostic Imaging

- MRI

- CT scan

- Neurological assessment

2. Functional Rehabilitation

- Visual field training

- Adaptive strategies

- Assistive technologies

Conclusion

Visual field defects represent complex neurological and ophthalmological phenomena requiring comprehensive, multidisciplinary assessment and management.

Note : This document serves educational purposes exclusively and does not constitute medical advice or treatment guidelines