Merck Manual

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Types of Field Defects

Types of Field Defects

Type*

Description

Causes

Altitudinal field defect

Loss of all or part of the superior or inferior half of the visual field; does not cross the horizontal median

Arcuate scotoma

A small, bow-shaped (arcuate) visual field defect that follows the arcuate pattern of the retinal nerve fibers; does not cross the horizontal median

Damage to ganglion cells that feed into a particular part of the optic nerve head

Binasal field defect (uncommon)

Loss of all or part of the medial half of both visual fields; does not cross the vertical median

Rare: Bilateral occipital disease, tumor or aneurysm compressing both optic nerves

Bitemporal hemianopia

Loss of all or part of the lateral half of both visual fields; does not cross the vertical median

Less common: Tilted optic disks

Rare: Nasal retinitis pigmentosa

Blind-spot enlargement

Enlargement of the normal blind spot at the optic nerve head

Central scotoma

A loss of visual function in the middle of the visual field

Rare: Occipital cortex lesion

Constriction of the peripheral fields, leaving only a small residual central field

Loss of the outer part of the entire visual field in one or both eyes

Rare: Drugs

Homonymous hemianopia

Loss of part or all of the left half or right half of both visual fields; does not cross the vertical median

Optic tract or lateral geniculate body lesion; lesion in temporal, parietal, or occipital lobe (more commonly, stroke or tumor; less commonly, aneurysm or trauma); migraine (which may cause transient homonymous hemianopia)

*Migraine can cause various visual field defects, although it most commonly causes homonymous hemianopia.

Adapted from Rhee DJ, Pyfer MF: The Wills Eye Manual, ed. 3. Philadelphia, Lippincott Williams &Wilkins, 1999.