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Visual fields in neuro-ophthalmology.

Kedar S, Ghate D, Corbett JJ - Indian J Ophthalmol (2011 Mar-Apr)

Bottom Line: Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up.They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin.Visual field testing must be performed in all patients with lesions of the visual pathway.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA. drsachinkedar@gmail.com

ABSTRACT
Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up. Standard automated perimetry has been shown to be adequate in neuro-ophthalmic practise and is now the technique of choice for a majority of practitioners. Goldman kinetic visual fields are useful for patients with severe visual and neurologic deficits and patients with peripheral visual field defects. Visual fields are useful in monitoring progression or recurrence of disease and guide treatment for conditions such as idiopathic intracranial hypertension (IIH), optic neuropathy from multiple sclerosis, pituitary adenomas, and other sellar lesions. They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin. Visual field defects can adversely affect activities of daily living such as personal hygiene, reading, and driving and should be taken into consideration when planning rehabilitation strategies. Visual field testing must be performed in all patients with lesions of the visual pathway.

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(a) Visual fields of a 38-year-old who complained of severe difficulty reading, shows a right inferior homonymous scotoma. (b) MRI brain of the same patient shows a lesion in the superior bank of the left calcarine cortex
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Figure 0003: (a) Visual fields of a 38-year-old who complained of severe difficulty reading, shows a right inferior homonymous scotoma. (b) MRI brain of the same patient shows a lesion in the superior bank of the left calcarine cortex

Mentions: Homonymous hemianopia causes patients to have impairment of daily activities such as personal hygiene, meal preparation, driving, shopping, and telephone usage.[68] Patients with homonymous hemianopia involving the central 5° complain of difficulty in reading, and are classified as “hemianopic dyslexia” [Fig. 3].[69] Patients with homonymous paracentral scotoma may be impaired while driving despite having a relatively large visual field intact. The scotomatous area often overlies the side-view mirror on one side and impairs the ability to change lanes safely. The subject of minimum visual field requirements for driving has been one of much debate. Hemianopic patients have demonstrated poor blind side hazard detection for pedestrians that were not compatible with driving in driving simulators.[70] Patients with hemianopia and quadrantanopia (especially inferior quadrantic defects) were noted to have difficulty with lane position/lane change, steering steadiness, and gap judgment compared to normal controls.[71] Other studies dispute the importance of visual fields for driving safety and standards[72] and suggest that assessment of on-road driving performance under the supervision of a trained specialist may be the best option. The International Council of Ophthalmology (ICO) recommends a binocular continuous field of 120° in the horizontal meridian split approximately between the right and left halves[73] as the minimum visual field requirement for driving.


Visual fields in neuro-ophthalmology.

Kedar S, Ghate D, Corbett JJ - Indian J Ophthalmol (2011 Mar-Apr)

(a) Visual fields of a 38-year-old who complained of severe difficulty reading, shows a right inferior homonymous scotoma. (b) MRI brain of the same patient shows a lesion in the superior bank of the left calcarine cortex
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3116538&req=5

Figure 0003: (a) Visual fields of a 38-year-old who complained of severe difficulty reading, shows a right inferior homonymous scotoma. (b) MRI brain of the same patient shows a lesion in the superior bank of the left calcarine cortex
Mentions: Homonymous hemianopia causes patients to have impairment of daily activities such as personal hygiene, meal preparation, driving, shopping, and telephone usage.[68] Patients with homonymous hemianopia involving the central 5° complain of difficulty in reading, and are classified as “hemianopic dyslexia” [Fig. 3].[69] Patients with homonymous paracentral scotoma may be impaired while driving despite having a relatively large visual field intact. The scotomatous area often overlies the side-view mirror on one side and impairs the ability to change lanes safely. The subject of minimum visual field requirements for driving has been one of much debate. Hemianopic patients have demonstrated poor blind side hazard detection for pedestrians that were not compatible with driving in driving simulators.[70] Patients with hemianopia and quadrantanopia (especially inferior quadrantic defects) were noted to have difficulty with lane position/lane change, steering steadiness, and gap judgment compared to normal controls.[71] Other studies dispute the importance of visual fields for driving safety and standards[72] and suggest that assessment of on-road driving performance under the supervision of a trained specialist may be the best option. The International Council of Ophthalmology (ICO) recommends a binocular continuous field of 120° in the horizontal meridian split approximately between the right and left halves[73] as the minimum visual field requirement for driving.

Bottom Line: Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up.They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin.Visual field testing must be performed in all patients with lesions of the visual pathway.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA. drsachinkedar@gmail.com

ABSTRACT
Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up. Standard automated perimetry has been shown to be adequate in neuro-ophthalmic practise and is now the technique of choice for a majority of practitioners. Goldman kinetic visual fields are useful for patients with severe visual and neurologic deficits and patients with peripheral visual field defects. Visual fields are useful in monitoring progression or recurrence of disease and guide treatment for conditions such as idiopathic intracranial hypertension (IIH), optic neuropathy from multiple sclerosis, pituitary adenomas, and other sellar lesions. They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin. Visual field defects can adversely affect activities of daily living such as personal hygiene, reading, and driving and should be taken into consideration when planning rehabilitation strategies. Visual field testing must be performed in all patients with lesions of the visual pathway.

Show MeSH
Related in: MedlinePlus