AfraTafreeh.

com

Visual Fields
Jason Ryan, MD, MPH
Visual Fields
• Divided into four quadrants for each eye
• Quadrants tested individually

AfraTafreeh.com
 AfraTafreeh.com

Visual System

1. Optic Nerve
2. Optic Chiasm
3. Optic Tract L Eye R Eye
1 2
4/5: Optic radiations
LGN 3
5

Left Right
Posterior Posterior
Lobe Lobe
Visual System
Key Points

• Left side of world → right cortex

• Right side of world→ left cortex
• Optic nerve carries signals from right/left retina
• Optic chiasm
AfraTafreeh.com
• Crossing of fibers from middle of both retina
• Carrying signals from lateral (temporal) images

L Eye R Eye
1 2
 AfraTafreeh.com

Visual System
Key Points

• Lateral geniculate nucleus

• Found in thalamus
• Major termination site of retinal projections
• Projections LGN → visual cortex
• Optic radiations
• Meyer’s loop (temporal lobe) L Eye R Eye
1 2
• Parietal lobe
LGN 3
5

Left Right
Posterior Posterior
Lobe Lobe
Anopia

L Eye R Eye
AfraTafreeh.com 1
1
Left Optic Nerve Compression
Left Retinal Lesion

Left Right
Posterior Posterior
Lobe Lobe
 AfraTafreeh.com

Optic Neuritis
• Inflammatory, demyelinating disease
• Acute monocular visual loss
• Highly associated with MS
• Presenting feature 15 to 20%
• Occurs 50% during course of illness
Amaurosis Fugax
• Painless, transient vision loss in one eye
• Classic description: curtain shade over vision
• Damage to optic nerve or retina
• Symptom of TIA
AfraTafreeh.com
• Often embolism to retinal artery
• Common source is carotid artery
 AfraTafreeh.com

Bitemporal Hemianopsia

2
L Eye R Eye
Optic Chiasm Compression
Pituitary Tumor/Aneurysm

Left Right
Posterior Posterior
Lobe Lobe
Bitemporal Hemianopsia

AfraTafreeh.com

Nunh-huh /Wikipedia
 AfraTafreeh.com

Homonymous Hemianopsia

Left PCA Stroke

Left Optic Tract Lesion
Right visual loss
L Eye R Eye

Right PCA Stroke

Right Optic Tract Lesion
Left visual loss
Left Right
Posterior Posterior
Lobe Lobe
Homonymous Hemianopsia

AfraTafreeh.com

Nunh-huh /Wikipedia
 AfraTafreeh.com

Macular Sparing
• Macula: central, high-resolution vision
• Often a dual blood supply: MCA and PCA
• PCA strokes often spare the macula
Quadrantic Anopia

5
Meyer’s Loop
L Eye R Eye Temporal Lobe
AfraTafreeh.com “Pie in the sky”
5 Temporal lobe damage

4
Left Right 4
Posterior Posterior Parietal Lobe
Lobe Lobe “Pie in the floor”
Parietal lobe damage