Hemianopsia

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Hemianopsia

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A 35-year-old woman comes to the office because of a six month history of progressively worsening headaches. She has also noticed blurred peripheral vision while driving. The patient does not report any head trauma or associated dizziness, weight changes, diplopia, or polyuria. Past medical history is unremarkable and she does not take any medications. Vitals are within normal limits. Physical examination demonstrates a bitemporal visual field defect. Laboratory studies reveal a prolactin level that is greater than 20 times normal and cranial imaging shows a large pituitary mass. Based on the diagram below, which of the following visual pathways is most likely disrupted in this patient?  The patient does not report any head trauma or associated dizziness, weight changes, diplopia, or polyuria. Past medical history is unremarkable and she does not take any medications. Vitals are within normal limits. Physical examination demonstrates a bitemporal visual field defect. Laboratory studies reveal a prolactin level that is greater than 20 times normal and cranial imaging shows a large pituitary mass. Based on the diagram below, which of the following visual pathways is most likely disrupted in this patient?  


External References

First Aid

2024

2023

2022

2021

Hemianopia p. 526, 557

Hemianopia with macular sparing p. 557

Quadrantic hemianopia

lower p. 557

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Summary

Hemianopsia refers to a decrease in vision or blindness in one-half of the visual field. Hemianopsia can be caused by damage to the brain (e.g., stroke or brain tumor), eye, or optic nerve. People with hemianopsia may have trouble seeing things on the side of their field of vision opposite to the damaged side. For example, if the right side of their brain has been damaged, they may have trouble seeing anything on the left side of their visual field.