Jump to content

Bitemporal hemianopia

Recommended Posts

  • Chief Cushie

From http://internalmedicinemrcp.blogspot.com/


When I was in UK, I attended a PACES course. There were 3 patients whom I was asked to examine the visual fields and the findings were bitemporal hemianopia. They also had a scar as shown above. In fact, they had craniopharyngioma which has been operated via a transfrontal approach. You don't always get a clear scar like this in the exam. So, sometimes you have to look in between the hairs for the scar.



Where is the lesion ? Optic chiasm


If you are asked to examine the eyes,

1) Inspection for scars (transfrontal and transphenoidal)

2) Examine the visual acuity with a Snellen chart

3) Test the visual fields (you will find bitemporal hemianopia)

4) Check light reflex and look for RAPD(relative afferent pupillary light reflex or Marcus Gunn pupil), accomadation reflex

5) Check eye movements

6) Do a fundoscopy ( look for optic atrophy, particularly if there is RAPD)

7) Look for a medic alert bracelet

8) Look for other features of endocrinopathy eg acromegaly, Cushing's syndrome which should also have been picked up during inspection

The other causes of a chiasmal lesion include pituitary adenoma, meningioma, aneurysm, glioma

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Create New...