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Visual field defects (Aetiology (Optic chiasm
Vascular: large internal…
Visual field defects
Aetiology
Optic chiasm
Vascular: large internal carotid artery aneurysm
Neoplastic: craniopharyngoma, meningioma, pituitary tumour
Optic tract
Vascular: stroke, haemorrhage
Autoimmune: MS
Neoplastic: CNS tumour
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Diagnosis
Examination
CN exam
Reduced fields, any other pathology
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Investigations
Bloods
FBC, CRP/ESR, U+E, LFT,
clotting, bone profile
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-
CSF
MCS, cytology
oligoclonal bands
History
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FH
Visual disorder,
neurological disorder
PMH
Known medical conditions,
neurological disorder
SH
Living arrangements,
occupation, smoking, alcohol, drugs
PC/HPC
Visual change (SOCRATES),
pain, fever, weakness
Pathophysiology
Physiology
Optic nerve tract formed from temporal retina (medial view) and nasal retina (lateral view) from each eye
At optic chiasm, nasal tracts cross, so L temporal and R nasal to left hemisphere, R temporal and L nasal to right
So right side of vision controlled by L hemi and vice versa
Tract goes to lateral geniculate body then splits into superior and inferior radiations (lower and upper vision) then visual cortex)
Defect
Lesion can occur anywhere along the tracts
Monocular blindness
Bitemporal hemianopia
Homonymous hemianopia
Upper/lower L/R quadrantinopia
Cortical blindness
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Definition
Alteration in the visual
field, resulting in reduced
field in one or both eyes