Skip to main content
SpringerLink
Log in

Neuro-Ophthalmological Examination in Homonymous Visual Field Defects

  • Chapter
  • First Online:
Homonymous Visual Field Defects

  • 1125 Accesses

Abstract

Homonymous hemianopia is the hallmark of postchiasmal brain damage and a sign of serious underlying neurological disease. Patients are often unaware of their visual deficit and may present with vague symptoms. However, there are various neuro-ophthalmological signs, which will alert the clinician to the possibility of a homonymous visual field defect. First, precise history taking and questions about quality of life are of outmost importance in order to proceed to the appropriate diagnostic investigations. Although perimetry is the mainstay for diagnosis in patients with suspected homonymous visual field defects, there are numerous additional tests, which provide useful information regarding the etiology, extent, localization, and functional significance of the underlying brain lesion. Even in the era of modern neuroimaging, the clinician should assess visual acuity, color vision, ocular motility, reading ability, pupil responses, neuropsychological status, and also perform funduscopy and optical coherence tomography, in order to make an individualized assessment and choose the most appropriate therapeutic and rehabilitation interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Zhang X, Kedar S, Lynn MJ, Newman NJ, Biousse V. Homonymous hemianopia in stroke. J Neuroophthalmol. 2006;26(3):180–3.

    Article  PubMed  Google Scholar 

  2. Levin LA, Arnold AC. Neuro-ophthalmology: the practical guide. New York/Stuttgart: Thieme Medical Publishers; 2005.

    Book  Google Scholar 

  3. Schiefer U, Wilhelm H, Hart W. Clinical neuro-ophthalmology: a practical guide. Berlin/Heidelberg/New York: Springer; 2007.

    Book  Google Scholar 

  4. Rondot P, Odier F, Valade D. Postural disturbances due to homonymous hemianopic visual ataxia. Brain. 1992;115(Pt 1):179–88.

    Article  PubMed  Google Scholar 

  5. Huber A. Vision disorders in retrochiasmatic lesions of the visual pathways. Ther Umsch. 1996;53(1):31–6. [Article in German].

    CAS  PubMed  Google Scholar 

  6. Kölmel HW. Die homonymen Hemianopsien, Klinik und Pathophysiologie zentraler Sehstörungen. Berlin/Heidelberg/New York: Springer; 1988.

    Book  Google Scholar 

  7. Miller NR, Newman NJ, Biousse V, Kerrison JB. Walsh & Hoyt’s clinical neuro-ophthalmology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.

    Google Scholar 

  8. Spector RH. Visual fields. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. 3rd ed. Boston: Butterworths; 1990.

    Google Scholar 

  9. Lorenz B, Borruat FX. Pediatric ophthalmology, neuro-ophthalmology, genetics. In: Krieglstein GK, Weinreb RN, editors. Essentials in ophthalmology. Berlin/Heidelberg/New York: Springer; 2008.

    Google Scholar 

  10. Peli E, Satgunam P. Bitemporal hemianopia; its unique binocular complexities and a novel remedy. Ophthalmic Physiol Opt. 2014;34(2):233–42.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kardon R, Kawasaki A, Miller NR. Origin of the relative afferent pupillary defect in optic tract lesions. Ophthalmology. 2006;113(8):1345–53.

    Article  PubMed  Google Scholar 

  12. Papageorgiou E, Ticini LF, Hardiess G, Schaeffel F, Wiethoelter H, Mallot HA, et al. The pupillary light reflex pathway: cytoarchitectonic probabilistic maps in hemianopic patients. Neurology. 2008;70(12):956–63.

    Article  CAS  PubMed  Google Scholar 

  13. Wray SH. Eye movement disorders in clinical practice: signs and syndromes. New York: Oxford University Press; 2014.

    Book  Google Scholar 

  14. Kennard C, Leigh RJ. Neuro-ophthalmology. In: Aminoff MJ, Francois Boller F, Swaab DF, editors. Handbook of clinical neurology, vol. 102. 1st ed. Amsterdam: Elsevier; 2011.

    Google Scholar 

  15. Barton JJ, Benatar M. Field of vision: a manual and atlas of perimetry. Totowa: Humana Press; 2003.

    Book  Google Scholar 

  16. Kerr NM, Chew SS, Eady EK, Gamble GD, Danesh-Meyer HV. Diagnostic accuracy of confrontation visual field tests. Neurology. 2010;74(15):1184–90.

    Article  CAS  PubMed  Google Scholar 

  17. Kline LB, Foroozan R. Neuro-ophthalmology review manual. 7th ed. Thorofare: Slack; 2013.

    Google Scholar 

  18. Hoyt WF, Kommerell G. Fundus oculi in homonymous hemianopia. Klin Monatsbl Augenheilkd. 1973;162(4):456–64. [Article in German].

    CAS  PubMed  Google Scholar 

  19. Goto K, Miki A, Yamashita T, Araki S, Takizawa G, Nakagawa M, et al. Sectoral analysis of the retinal nerve fiber layer thinning and its association with visual field loss in homonymous hemianopia caused by post-geniculate lesions using spectral-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2016;254(4):745–56.

    Article  PubMed  Google Scholar 

  20. Jindahra P, Petrie A, Plant GT. Retrograde trans-synaptic retinal ganglion cell loss identified by optical coherence tomography. Brain. 2009;132(Pt3):628–34.

    Article  PubMed  Google Scholar 

  21. Yamashita T, Miki A, Iguchi Y, Kimura K, Maeda F, Kiryu J. Reduced retinal ganglion cell complex thickness in patients with posterior cerebral artery infarction detected using spectral-domain optical coherence tomography. Jpn J Ophthalmol. 2012;56(5):502–10.

    Article  PubMed  Google Scholar 

  22. Herro AM, Lam BL. Retrograde degeneration of retinal ganglion cells in homonymous hemianopsia. Clin Ophthalmol. 2015;9:1057–64.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Cowey A, Alexander I, Stoerig P. Transneuronal retrograde degeneration of retinal ganglion cells and optic tract in hemianopic monkeys and humans. Brain. 2011;134(Pt 7):2149–57.

    Article  PubMed  Google Scholar 

  24. Lambert SR, Kriss A, Taylor D. Detection of isolated occipital lobe anomalies during early childhood. Dev Med Child Neurol. 1990;32(5):451–5.

    Article  CAS  PubMed  Google Scholar 

  25. Hoyt CS, Taylor D. Pediatric ophthalmology and strabismus. 4th ed. Edinburgh/London/New York: Elsevier Saunders; 2013 (Expert Consult).

    Google Scholar 

  26. Kedar S, Zhang X, Lynn MJ, Newman NJ, Biousse V. Pediatric homonymous hemianopia. J AAPOS. 2006;10(3):249–52.

    Article  PubMed  Google Scholar 

  27. Brodsky MC. Pediatric neuro-ophthalmology. 3rd ed. New York: Springer; 2010.

    Book  Google Scholar 

  28. Rosenbaum AL, Santiago AP. Clinical strabismus management: principles and surgical techniques. Philadelphia: W.B. Saunders Company; 1999.

    Google Scholar 

  29. Mehta JS, Plant GT. Optical coherence tomography (OCT) findings in congenital/long-standing homonymous hemianopia. Am J Ophthalmol. 2005;140(4):727–9.

    Article  PubMed  Google Scholar 

  30. Keane JR. Hysterical hemianopia. The ‘missing half’ field defect. Arch Ophthalmol. 1979;97(5):865–6.

    Article  CAS  PubMed  Google Scholar 

  31. Hershenfeld SA, Sharpe JA. Monocular temporal hemianopia. Br J Ophthalmol. 1993;77(7):424–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Bruce BB, Newman NJ. Functional visual loss. Neurol Clin. 2010;28(3):789–802.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Keane JR. Patterns of hysterical hemianopia. Neurology. 1998;51(4):1230–1.

    Article  CAS  PubMed  Google Scholar 

  34. Trauzettel-Klosinski S. Examination strategies in simulation and functional vision disorders. Klin Monbl Augenheilkd. 1997;211(2):73–83. [Article in German].

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University Hospital of Larissa, Mezourlo, Larissa, 41110, Greece

    Eleni Papageorgiou MD, PhD, FEBO & Evangeli Tsironi-Malizou MD, PhD

Authors
  1. Eleni Papageorgiou MD, PhD, FEBO
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Evangeli Tsironi-Malizou MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eleni Papageorgiou MD, PhD, FEBO .

Editor information

Editors and Affiliations

  1. Department of Ophthalmology and Optometry, St. Anne’s University Hospital, Brno, Czech Republic

    Karolína Skorkovská

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Papageorgiou, E., Tsironi-Malizou, E. (2017). Neuro-Ophthalmological Examination in Homonymous Visual Field Defects. In: Skorkovská, K. (eds) Homonymous Visual Field Defects. Springer, Cham. https://doi.org/10.1007/978-3-319-52284-5_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-52284-5_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52282-1

  • Online ISBN: 978-3-319-52284-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation