Visual Field 4

Question 1

what kind of defect will lids/ptosis make

Answer 1

will give a superior defect/depression bc they are in front of the nodal point
-sup defect secondary to location to nodal point

Question 2

how does the corneal dystrophy look
MD, total dev, pattern dev?

what kind of vf loss?

Answer 2

MD decreased
total deviation decreased
pattern deviation looks normal

diffuse visual field loss secondary to cornea irregulatirty

Question 3

how can cataracts affect vf

Answer 3

• usually associated w/ generalized overalld epression, esp nuclear opacities
• can be assoicated w/ scotomas or localized depression depending on location and density

Question 4

what does a posterior cortical do to vf

Answer 4

diffuse overall field loss, all #s down

Question 5

what does a posterior subcapsular cataract do?

Answer 5

right on the axis, so field loss is closer to fixation and will look like a relative scotoma

Question 6

what does a big cataract in the anterior lens do? posterior lens?

Answer 6

anterior lens: it will be before the nodal point and therefore cause a field loss in the same relative area (inf lens gives inf defect)

posterior lens: may or may not be found in front of the nodal point, so it will be harder to predict the defect location

Question 7

where are the four main territories for defects after the nodal point?

Answer 7

territory 1: retinal rods and cones
territory 2: retinal ganglion cells and axons, NFL and optic nerve
territory 3: optic chiasm, usually cuased by pituitary adenomas
territory 4: optic tract, LGN, optic radiations, visual cortex

Question 8

in the retinal defect position, how will the vf defect look

Answer 8

vf defect will be inverted and reversed from the retinal defect (territory 1)

Question 9

what are some retinal issue that can create vf defects

Answer 9

macular degeneration: geographic macular degeneration “retinal rot”-field loss close to fixation, prob dense central scotoma
-macula hole (test w/ amsler 20/200)

retinal detachment: if detachment sup, get inf depression, usually sloping margins

retinitis pigmentosa: bone spicules start mid-periphery, usually btwn 25 and 50 from fixation, gives a ring scotoma as a result, night blindness

Question 10

waht do lesions interrupting the papillomacular bundle produce

Answer 10

either a central scotoma or a centrocecal (cecocentral) scotoma

Question 11

how does a central scotoma develop?

how does a centrocecal scotoma develop?

Answer 11

central: develop when the macular ganglion cells or their axons malfunction
centrocecal: caused by involvement of ganglion cells or axons rising both from the fovea and from the retina btwn the fovea and the optic disc

Question 12

how do arcute bundles look

what do lesions interrupting the arcuate bundle produce?

Answer 12

surround the papillomacular bundle and are arcuate (arching) nerve fibers originating from above, below, and temporal to the fovea and converging upon the sup and inf poles of the optic nerve
-bundles sep into upper and lower portions which are divided by a line that corresponds to the nasal horiz meridian

-produce either arcuate defects or portions of arcuate defects

Question 13

the fibers nearest the optic nerve travel most ______ in the retina and enter the optic nerve most _______

Answer 13

superficially
centrally

-this is why the last thing to go in glauc is the far periphery, but doesnt explain why the field loss in glauc starts as a paracentral anywehre btwn 5 and 20 degrees of fixation

Question 14

how do nerve fiber bundles converge in a temporal wedge?

Answer 14

nerve fiber bundles originating in the ganglion cells nasal to the optic disc converge upon the disc radially in a wedge like pattern

Question 15

what meridian do optic nerve defects respect

Answer 15

usually respect the horizontal meridian nasally and not temporally
-do not respect the vertical

Question 16

what is the most common eye conditions which create territory 2 defects

Answer 16

most common is glaucoma

• paracentral 70%
• nasal step 5%
• both paracentral and nasal step 10%
• temporal wedge 5%

Question 17

what are some eye conditions which create territory 2 defects

Answer 17

glaucoma
myelinated nerve fibers
drusen on the ONH 
papilledema 
optic neuritis
ischemic optic neuropathy

Question 18

what are territory 3 defects caused by?

where is the pituitary located related to the chiasm?

Answer 18

pituitary adenomas

pituitary is located inf to the chiasm

Question 19

what causes a classic bitemporal hemianopsia?

Answer 19

tumors press on both the inf chiasm and its blood supply and produce that

Question 20

what do territory 4 defects produce

Answer 20

homonymous hemianopsia

Question 21

occipital cortex lesion are usually ______

optic tract and radiations produce _______ hemianopsia

Answer 21

congruous

incongruous

Question 22

how do you name the field loss

Answer 22

by the field that is missing

ex. right part of field missing it is right homonymous and damage will be on the left side of the brain

Question 23

what is the frequency doubling controlled by

Answer 23

magnocellular pathway

-M cells responsible for low-contrast, high temporal frequency stimulus detection

Question 24

-my cells are ___% of the total axons in the eye

Answer 24

15%

5%

Question 25

what is a microperimetry

Answer 25

cross btwn a fundus camera and a perimeter

-the vf are superimposed over the fundus area it is very good for macula disease