Types of Field Defects

Type* Description Causes

More common: Ischemic optic

Loss of all or part
neuropathy, hemibranch retinal
of the superior or
artery occlusion, retinal
Altitudinal field inferior half of the
detachment
defect visual field; does
Less common: Glaucoma, optic
not cross the
nerve or chiasmal lesion, optic
horizontal median
nerve coloboma

A small, bow-
shaped (arcuate) Damage to ganglion cells that feed
visual field defect into a particular part of the optic
that follows the nerve head
Arcuate scotoma arcuate pattern of More common: Glaucoma
the retinal nerve Less common: Ischemic optic
fibers; does not neuropathy (usually nonarteritic),
cross the optic disk drusen, high myopia
horizontal median

Loss of all or part More common: Glaucoma,

of the medial half bitemporal retinal disease
Binasal field
of both visual (eg, retinitis pigmentosa)
defect
fields; does not Rare: Bilateral occipital disease,
(uncommon)
cross the vertical tumor or aneurysm compressing
median both optic nerves

More common: Chiasmal lesion

Loss of all or part
(eg, pituitary
of the lateral half
adenoma, meningioma,
Bitemporal of both visual
craniopharyngioma,
hemianopia fields; does not
aneurysm, glioma)
cross the vertical
Less common: Tilted optic disks
median
Rare: Nasal retinitis pigmentosa

Blind-spot Enlargement of Papilledema, optic nerve drusen,

enlargement the normal blind optic nerve coloboma, myelinated
Type* Description Causes

nerve fibers at the optic disk,

drugs, myopic disk with a crescent,
acute zonal occult outer
spot at the optic retinopathy (AZOOR) spectrum of
nerve head disease, multiple evanescent white
dot syndrome (MEWDS), acute
idiopathic blind spot enlargement
(AIBSE) syndrome

Macular disease, optic neuropathy

(eg, ischemic or Leber hereditary
A loss of visual
neuropathy, optic neuritis-multiple
function in the
Central scotoma sclerosis), optic atrophy (eg, due to
middle of the
tumor compressing the nerve or
visual field
toxic-metabolic disorders)
Rare: Occipital cortex lesion

Glaucoma, retinitis pigmentosa or

another peripheral retinal
disorder, chronic papilledema,
Constriction of panretinal photocoagulation,
the peripheral Loss of the outer central retinal artery occlusion
fields, leaving part of the entire with cilioretinal artery sparing,
only a small visual field in one bilateral occipital lobe infarction
residual central or both eyes with macular sparing,
field nonphysiologic vision loss, cancer-
associated retinopathy
Rare: Drugs
(eg, hydroxychloroquine)

Homonymous Loss of part or all Optic tract or lateral geniculate

hemianopia of the left half or body lesion; lesion in temporal,
right half of both parietal, or occipital lobe (more
visual fields; does commonly, stroke or tumor; less
not cross the commonly, aneurysm or trauma);
vertical median migraine (which may cause
Type* Description Causes

transient homonymous
hemianopia)

* Migraine can cause various visual field defects, although it most commonly
causes homonymous hemianopia.

Adapted from Bagheri N, Wajda BN: The Wills Eye Manual: Office and emergency
room diagnosis and treatment of eye disease, ed. 7. Philadelphia, Lippincott
Williams &Wilkins, 2016.