Bilateral hemianopia. Treatment of homonymous hemianopsia

25.08.2023

Bilateral hemianopsia is a neurological disorder characterized by bilateral blindness in half of the visual fields. Tractus hemianopsia (from the word "path") is caused by damage to the optic pathways, and central hemianopsia develops when the cortical regions responsible for visual perception are damaged. In other words, hemianopsia is the loss of half of the visible vision on the left or right, but always in both eyes.

Damage to the optic tracts usually ends with the death of the optic nerves. With a central origin of the disease, the optic nerves do not atrophy and continue to function.

Loss of visual fields by origin is divided into acquired and congenital. The congenital variant occurs in violation of the development of the central nervous system during fetal maturation. Almost always combined with other defects of the nervous system and rarely occurs as an isolated pathology. The acquired variant develops mainly in people whose average age is from 30 to 50 years. More common in women.

Causes

Hemianopsia occurs when the visual tracts, cortex or subcortical regions are damaged. It follows that it is necessary to look for the nature of damage to the visual system.

Pathology of the blood circulation of the brain against the background of blockage of the arteries by atherosclerosis or arterial hypertension. They lead to an acute shortage of blood in the vessels, as a result of which parts of the brain die from a lack of oxygen and nutrients. The type of pathology of the visual fields is determined by the pool and the area of \u200b\u200bthe brain in which the blood flow is disturbed. Often, vision is impaired when the blood supply to the posterior cerebral artery, which supplies blood to the occipital and parietal cortex, is reduced. With a stroke or aneurysm, intracranial pressure increases and hemorrhage into the brain tissue is provoked, visual pathways are damaged.
Inflammation of the meninges and parenchyma of the brain. Inflammation of the membranes, if it is localized mainly in the subcortical structures, compresses the brain and causes mechanical compression. This impairs the conduction of nerve impulses.
Volumetric processes in the skull: tumor, cyst, purulent accumulation.
iatrogenic factor. During CNS surgery, a neurosurgeon may inadvertently damage the optic pathways.
Congenital defects of the central nervous system, accompanied by a gross violation of the brain or hypertension syndrome: dropsy, microcephaly, encephalocele or dysplasia of the tissues of the telencephalon.

A special case of field loss, for example, homonymous hemianopsia on the left, is determined by the area of brain damage.

Varieties

There are several types of neurological disease:

Homonymous hemianopsia (homonymous hemianopsia)

Unilateral hemianopsia is an incomplete loss of vision. It is characterized by the loss of margins on the right or left. Homonymous hemianopsia occurs when CNS structures are damaged by infection, stroke, or mechanical trauma.

Features of the pathology. The homonymous variant is reversible. So, right- or left-sided blindness can be a sign of aura in migraine. Aura is the preceding stage of a unilateral headache. Hemianopsia of the same name can be one of the signs of a stroke. Contralateral hemianopsia occurs with unilateral damage to the optic nerve. For example, if the optic nerve is damaged on the left, the right lateral visual fields will fall out and right-sided homonymous hemianopia (right hemianopsia) will occur. If the right optic nerve is damaged, there will be left-sided homonymous hemianopia. With a complete lesion of the external geniculate body, a complete unilateral hemianopia occurs.

Bitemporal heteronymous hemianopia

By expanding each word, you can understand the term. “B” is two, “temporal” is the side of the temples of the head. Pathology is manifested by the disappearance of both fields of vision from the side of the temples. Bitemporal hemianopsia is observed when the optic pathway is damaged in the area where the optic nerves intersect with each other.

Heteronymous hemianopsia occurs when the optic nerves are damaged, which is most often caused by a tumor. Often these are neoplasms in or above the pituitary gland. Temporal hemianopsia is often a symptom of a pituitary adenoma.

Bi is two, that is, on both sides, nasal - meaning the bow. Pathology is characterized by bilateral loss of visual fields in the nasal part of the face. Binasal hemianopsia occurs when the optic tract and brain structures are damaged. Also, binasal hemianopsia occurs when the central nervous system is damaged against the background of dropsy of the brain.

Upper quadrant hemianopsia

Unlike previous types of visual field loss, this quadrant hemianopsia is characterized by loss of the upper half of the vision. Upper hemianopsia develops due to damage to the ventral optic tract.

Lower quadrant hemianopsia

It is characterized by a loss of the lower part of the vision on both sides. Lower quadrant homonymous hemianopsia occurs when the posterior optic tract or parietal cortex is damaged. So with the defeat of the parietal cortex, complete hemianopia occurs.

Clinical picture

Patients suffering from pathology often face everyday discomfort. The visual defect does not allow a person to see objects in the field of vision that has fallen out. For patients, ordinary phenomena, such as crossing a road, turn into a danger: a person cannot see an approaching car. People are not recommended to drive any transport, as there is a risk of accidents.

The fields of vision that have fallen out do not even allow you to see the food on the second half of the plate, there are difficulties in reading, since the other half of the page of the book is not visible. Reading for people turns into flour: people need to make more eye movements.

Neurological ailment is accompanied by elementary visual hallucinations. Photopsy is the perception of non-existent ugly phenomena and objects, for example, a suddenly appeared dot, flashes, lightning or lights. Often, elementary visual hallucinations in hemianopsia occur after a recent stroke.

Everyday life and elementary household items cause psychological discomfort in patients: their actions from the outside seem ridiculous, sloppy. Some patients develop depression and other neurotic disorders. As a result of loss of visual fields and a sense of incapacity, some patients withdraw from social life, preferring to spend time alone.

For patients with hemianopsia, the range of possible specialties is limited. Thus, such patients cannot carry passengers or work in places where an external assessment of objects is required, for example, in engineering or construction.

The clinical picture of visual impairment, in addition to photopsies, is supplemented by agnosia. This is a neurological disorder characterized by impaired recognition of objects in the visual channel. Patients often have prosopagnosia, a disorder in recognizing familiar faces. Some patients have Anton-Babinsky syndrome: people deny the existence of their pathology.

Congenital hemianopsia is often combined with defects in the development of the subcortical and cortical parts of the brain: the thalamus, brain stem, and parietal cortex. Therefore, the clinical picture is supplemented by such pathologies:

Paresthesias are perverse sensations. So, patients often suffer from tingling of the skin, complain of flying flies before their eyes.
Violation of deep sensitivity. Patients have impaired pain and tactile perception.

Classification

According to the topic of defeat, it happens:

Tractus hemianopia. It develops due to damage to the visual pathways. It is characterized by atrophy of the optic nerves, lack of pupillary response to light, and asymmetry of visual field loss.
Central hemianopia. It develops when the central parts of the brain are damaged. Pathology is not accompanied by atrophy of the optic nerves, no, they continue to respond to a light stimulus. The central variant is accompanied by a symmetrical loss of visual fields.

How is the disease detected?

Diagnosis of visual impairment is carried out by examining the visual fields. The purpose of the express technique is to identify field pathologies. In neurological practice, a special hand hammer is used. The neurologist sits opposite the person and asks him to close one eye with his palm. The look of an open eye is fixed on the doctor's nose. The physician slowly moves the instrument from behind the patient's head from the periphery to the center from all sides. The patient must be told immediately when he sees the hammer.

Among the instrumental methods, perimetry has the greatest diagnostic value. The procedure is carried out using the perimeter. As a result of the procedure, the doctor receives information about the boundaries of the visual fields for both eyes. Other visual defects are also detected. Computed campimetry is also used. It reveals violations of color perception in different areas of the retina and helps to establish the level of violation.

To identify the cause of the violation, computer and ultrasound diagnostics are used: computer and magnetic resonance imaging, ultrasound dopplerography of cerebral vessels. Computer diagnostics helps in the choice of treatment tactics, as it allows you to visualize the focus of hemorrhage, tumor or abscess.

Treatment

Principles of hemianopia treatment:

Etiological treatment aimed at eliminating the cause. Therapy depends on the identified cause. For example, if computer diagnostics revealed an ischemic focus, drugs are prescribed that eliminate hypoxia and brain ischemia. If it is an oncological disease, then chemotherapy or surgery is prescribed.
Socio-psychological recovery. Patients are taught to read and work with text. They are helped to increase the amplitude of eye movement so that a whole line on the page is visible.

If the cause cannot be eliminated, rehabilitation methods are applied. The patient is advised to use glasses with built-in mirrors to compensate for the lack of visibility.

Hemianopia does not reduce life expectancy, but it can reduce its quality and level. The prognosis for working capacity is determined by the etiology and type of anopsia. So, if the disease was detected immediately after a traumatic situation, for example, after a concussion, and immediately succumbed to treatment, the person is fully restored.

…for people with homonymous hemianopia, half the world simply does not exist.

Definition. Homonymous hemianopsia is a condition in which a person can only see one side, left or right, and is the result of damage to the part of the brain where visual signals come from the same visual fields in each eye. The visual signals from each eye are distributed along the optic nerves entering the brain such that damage to the left half of the brain causes loss of the right halves of the visual fields in each eye, and injury to the right half of the brain causes loss of the left halves of the visual fields in each eye.

Causes. Homonymous hemianopsia can be caused by any disorder that affects the brain, including tumors, inflammation, and trauma, but is most commonly caused by a stroke. Brain MRI is most commonly used to diagnose the location and cause of damage.

Homonymous hemianopsia occurs on the contralateral side with infarcts in the areas of blood supply to the hemispheric branches of the PCA (posterior cerebral artery) due to damage to the striate cortex, optic radiation, or lateral geniculate body. In the absence of involvement of the occipital pole, macular vision remains intact. The visual field defect may be limited to only one quadrant. Upper quadrant hemianopsia occurs when the striate cortex is infarcted below the spur sulcus or the lower part of the optic radiation in the temporoccipital region. Inferior quadrant hemianopsia is a consequence of damage to the striate cortex above the spur groove or the upper part of the optic radiation in the parietal-occipital region. Occlusion of the spur sulcus may also be associated with pain in the ipsilateral eye. Visual disturbances can be more complex, especially with bilateral occipital lobes, including visual hallucinations, visual and color agnosia, prosopagnosia (agnosia of familiar faces), blindness denial syndrome (Anton's syndrome), visual attention deficit, and optomotor agnosia ( Balint syndrome). Visual disturbances are often accompanied by afferent disturbances in the form of paresthesias, disorders of deep, pain and temperature sensitivity. The latter indicate the involvement of the thalamus, parietal lobe or brain stem (due to occlusion of the proximal parts of the vertebrobasilar basin).

It should be remembered that homonymous hemianopsia does not always imply an infarction in the PCA. The watershed boundaries of the basins of the middle and posterior cerebral arteries fluctuate considerably. Usually, the Sylvian sulcus serves as the boundary of the PCA basin, but sometimes the middle cerebral artery (MCA) also supplies blood to the outer sections of the occipital lobe up to the occipital pole. At the same time, the ZMA always supplies blood to the areas of the cerebral cortex in
area of the spur sulcus, and optic radiation in some cases receives blood from the MCA, respectively, homonymous hemianopsia does not always imply a heart attack in the PCA basin.

Symptoms. It is difficult to explain the sensations of patients with hemianopia without giving illustrative examples. For example, in patients with right-sided hemianopia, patients “feel” that the problem is in the right eye, but checking each eye individually shows that each eye does not see the right part of the visual field (Fig. 2).

People with homonymous hemianopia often bump into objects on the side of the visual field defect. Such an action as crossing the street can be dangerous, since the patient is not able to see the approaching traffic from the side of the hemianopia. Driving can be especially dangerous, as the patient may not be able to see an approaching car or other objects on the side of the hemianopia when changing lanes. Objects on the work or dining table located in the field of vision that have fallen out may not be visible, and sometimes even the food on the plate that falls out of sight remains uneaten. People with left-sided homonymous hemianopsia have a hard time finding a new line when they finish reading the previous one. When reading, the eyes make a series of small, rapid movements from one word or group of words to the next. Since we read from left to right, people with right-sided homonymous hemianopsia make more small movements just to read one word from beginning to end. This makes reading slow and frustrating for many patients. Homonymous hemianopsia is characterized by visual hallucinations, especially if it develops suddenly, such as after a stroke. These hallucinations can be "unformed" - lights, shapes, geometric shapes, or "formed", such as the image of a recognizable object. Sometimes an object from the saved field of view is reflected in the dropped field. For example, by moving a hand in the saved field of view, the patient can "see" the hand making the same movements in the field that has fallen out.

Visual acuity, which is characterized by the ability to see the smallest symbols on a vision chart, is not affected by homonymous hemianopia. Only half of the field of view disappears.

Diagnostics. Homonymous visual field defects are diagnosed by examining the visual fields. The neurological technique includes an approximate check of the visual fields. For this purpose, a neurological hammer is used. The doctor sits opposite the patient, the patient closes one eye with his hand, fixes the other eye motionless, for example, on the bridge of the doctor's nose. The doctor moves the hammer from behind the patient's head around the perimeter to the center, right, left, top and bottom. As soon as the malleus comes into view, the patient should report it. In this way, hemianopsia can be detected. Also, to detect hemianopsia, it is possible to conduct a control study using the following method. The patient and doctor stand opposite each other at a distance of about 100 mm. Their eyes are placed at the same level. Both the patient and the doctor need to cover one eye with a hand or a clean gauze bandage. The patient needs to look into the open eye of the ophthalmologist. The doctor begins to move the finger from the periphery to the central areas in turn in all directions. It is necessary that the finger be kept at an equal distance from the patient and from the doctor. When a finger appears in the visual field of the patient, the patient must be informed about this. If the doctor's indicators match the patient's data (and the doctor has good eyesight), then the patient's vision is normal. Another, even simpler method for detecting hemianopia is the "towel test". The patient is asked to divide the towel stretched in front of him in half with his hand (one eye is also closed). In the presence of hemianopia, the patient will divide the towel into unequal parts - 1/4 and 3/4 (i.e. half of what he sees). Identification of smaller visual field defects (quadrant anopsia or scotoma) requires perimetry (conventional or computerized).

In ophthalmology, several methods are used for the topical diagnosis of visual field defects associated with damage to different levels of the visual system: in the retina, optic nerve, at the level of the chiasm and above the underlying pathways and centers. Some of them are based on the use of devices - visual field analyzers, including automatic ones (perimetry and campimetry), which make it possible to study the light and color sensitivity of the visual system when stimulating local areas of the retina. Others are associated with the use of devices for determining the critical flicker fusion frequency (CFFM), which allow one to study the flicker sensitivity of the visual analyzer (read more about the use of devices for determining CFFF).

Treatment. Effective treatment of hemianopsia involves the complete elimination (treatment) of the main causes that caused the development of this disease (for example, stroke). If hemianopsia persists as a residual symptom, there are a number of approaches to make it easier for patients with homonymous hemianopia to read and interact with their environment. Reading can be made easier by consciously working to increase the size of small eye movements, to a single movement along a line of text. Many patients achieve this by holding text at a 90 degree angle and reading vertically. Patients with right-sided homonymous hemianopsia should rotate the text so that it is read from top to bottom, thereby keeping the next line of text in the preserved left visual field. Conversely, people with left-sided homonymous hemianopsia should rotate the text to read from bottom to top, for the same reason. At first glance, this may seem complicated, but remember how many teachers sit opposite their students and read with them a text that is turned 180 degrees in relation to them.

To facilitate movement in the external environment, you can turn your eyes towards the dropped out half of the field of view. A slightly different approach requires the search for objects in the dropped field of view. Research has shown that people with homonymous hemianopia typically make a series of small eye movements toward the field of vision they have dropped out when looking for something in it. It is more effective when the person consciously makes very large eye movements towards the blind field of vision and then allows the eyes to return to the object. When walking, the attendant should walk from the side of the dropped field of vision and allow the patient to hold on to it. Family members or close people should try as much as possible to be in the preserved field of view of the patient.

Prisms or mirrors have been used in spectacles to compensate for hemianopia. This method allows you to shift the direction of vision towards the visual field defect in order to draw attention to the objects in it. However, this approach still requires the patient to actively move their eyes in that direction in order to focus on the object. More formal attempts to restore the visual field with a computer program have been controversial. Ongoing research on the benefits of such programs should address the issue of their ability to produce a significant improvement in visual function in people with hemianopsia. In the meantime, caution must be exercised about investing great effort and money in any unproven treatment program. Low vision specialists may be familiar with these techniques for use with patients. Although, in general, none of these methods brings tangible improvements in the quality of life of patients. Patients participating in vision rehabilitation studies report some improvement, but it is often difficult to tell the difference between a placebo effect and a real benefit.

Homonymous hemianopsia: types, methods of treatment, prevention

Homonymous hemianopsia is a neurological disease that occurs as a result of damage to parts of the brain and manifests itself in visual impairment. People who have this pathology see only one side of the observed object.

When the left side of the brain is damaged, they lose the right side of the image and vice versa. If the problem lies in the work of the right half of the brain, then part of the picture on the left side disappears.

Pathology, depending on in which part of the eye the blindness occurs, can be divided into several types.

Homonymous. In it, in turn, the following subspecies are distinguished:

right-sided;
left-sided;
contralateral;
square.

Heteronymous. It includes:

Hemianopsia can also be complete and partial. In the first case, blindness covers the entire area of the visual field, and in the second - an insignificant part of it.

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homonymous

With this type of disturbance in the perception of the world, the patient sees only one half of the image field. The line between the part of the picture visible to a person, and what is considered a blind zone, is located vertically exactly in the center. Pathology can arise either due to disorders in the occipital lobe of the cerebral cortex, or due to lesions of the visual pathways.

With contralateral hemianopia, the patient does not see anything that is in the region of the nose of one eye and the temporal part of the other.

Right-sided hemianopsia is presented as a distortion of the perception of the world in the right parts of the left and right eyes. Left-sided - is characterized as a visual impairment, in which the left side of both eyes is considered a dead zone.

With a square variety, there is a loss of the image of only a quarter of the right and left eyes.

The manifestation of hemianopia depends on which side of the brain the affected area is affected.

Square hemianopsia

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Heteronymous

This pathology manifests itself in the occurrence of blindness in the nasal or temporal parts. The line separating the non-perceiving part from the visible part is horizontally exactly in the middle.

With bitemporal hemianopia, the blind zone is considered to be the lateral field of view from the side of both the right and left eyes. To be more precise, the picture disappears in the area of the temples.

With binasal hemianopia, the patient does not see with both eyes what is located in the nose.

In addition to unilateral, bilateral hemianopia can also develop. It is characterized by the occurrence of blindness in both halves of the eye.

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Scheme of damage to the brain and visual fields

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What diseases develop

Homonymous hemianopia can be either congenital or acquired. Its occurrence can provoke the following diseases:

Migraine. The development of hemianopsia is associated with impaired blood circulation in the optic nerve. It is accompanied by such signs as super-strong sensitivity of the eyes to light, nausea, increased hearing, and headaches. It arises due to the significant expansion of blood vessels located in the brain. Blind spots due to this pathology appear in those places where there was a violation of blood flow.
nephrotic syndrome.
Hydrocephalus. As a result of this pathology, too much fluid is accumulated in the brain. She puts pressure on his tissues. For this reason, vision problems arise.
Violations of blood circulation in the brain, such as stroke.
Epilepsy. Due to epileptic seizures, cerebral edema occurs. It leads to visual impairment. Before a seizure, the same symptoms may appear as before a migraine. The cause of the development of incomplete blindness can be both a hemorrhage that provoked epilepsy, and the seizure itself.
CNS disorders.
Neoplasms in the brain. Because of their occurrence in that part of it that is responsible for vision, its tissues begin to be compressed. This process causes loss of parts of vision.
body intoxication. Due to a thorough poisoning with ethyl alcohol, medications or any products, the quality of vision may also deteriorate.
Traumatic brain injury. They often cause tumors in the brain. It also puts pressure on those tissues in it that are responsible for the functioning of the organ of vision. As a result, partial blindness develops.

Visual impairment can be caused not only by damage to the occipital centers responsible for it, but also by anomalies in that area of the brain that, it would seem, have nothing to do with it.

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Stroke

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Treatment

Therapy for hemianopsia is prescribed based on what diseases it was caused by. Only after the first disease is cured, it will be possible to get rid of the second.

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So, how to treat:

In order to cope with blindness, which was caused by neoplasms, you will need to undergo a course of radiation or chemotherapy. Sometimes surgery is used to restore vision.
If its appearance is associated with migraine, then nasal sprays containing sumatriptan will help to cope with blindness.
If the cause of blindness was a stroke, then the patient will have to be prescribed restorative therapy. He will be prescribed medications that normalize blood circulation, as well as speed up the process of tissue repair. If the loss of vision was provoked by an ischemic stroke, then you will first need to eliminate blood clots in the vessels of the brain. For this, fibrinolytic enzyme medications will be used in the first few hours after it. In the hemorrhagic type, medications are prescribed that bring blood pressure back to normal. During rehabilitation, drugs are used that improve cerebral circulation.
If visual impairment is associated with any injuries, then surgical intervention will be required to restore it. Medical therapy is rarely prescribed.
If poor vision is provoked by an excess amount of fluid in the brain, then diuretics should be used.

If you do not treat the pathology, then you can soon remain completely blind. For this reason, if even minor vision problems appear, it is necessary to contact an ophthalmologist as soon as possible.

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Fields of vision with left-sided and right-sided type of ailment

Forecast and prevention

Vision will return completely or disappear completely, depending on the following factors:

patient's age;
the body's ability to recover quickly;
stage of pathology;
the severity of the disease, as a result of which hemianopsia developed;
features of therapy;
the duration of violations of the vision of the surrounding world;
additional complications.

Prevention of pathology includes a periodic examination by an ophthalmologist, as well as visits to specialists such as:

You should also not miss scheduled examinations, during which the presence of neoplasms is checked.

Scheduled medical examinations will help maintain eye health for many years.

Homonymous hemianopia is a serious disease. People who have it experience significant difficulties in reading books, driving a car and in many other situations. In most cases, it is possible to cope with this pathology, the main thing is to contact an ophthalmologist in a timely manner. The relatives of the patient should support him and try to always be in his line of sight.

Attention! The article is purely informational. Before treatment, you should consult a specialist.

Homonymous hemianopsia: causes and treatments

The medical term "hemianopia" refers to a condition in which there is an area of blindness in half of the visual field. The field of view is the region of space that a person sees without moving his eyes or turning his head. Hemianopsia is a bilateral "partial blindness", that is, the loss of half of the field of view of each eye.

There are various types of this kind of pathology of visual perception. It is possible to distinguish heteronymous hemianopsia (loss of opposite halves of the visual fields), there is also a partial, quarter (upper or lower) hemianopsia. "Darkening" of both temporal halves of the field is called bitemporal hemianopsia. The loss of parts of the visible space from the side of the nose is a binasal hemianopsia. A "blind spot" in the central part of the visual field is called a hemianopic scotoma.

Homonymous hemianopsia is a condition characterized by loss of the same halves of the visual fields. It can be both right or both left halves at the same time: a person can see only one part of the space that falls into the field of view (left or right). The boundary between the visible part and the "blind spot" in homonymous hemianopsia is the central vertical meridian.

Types and classifications

As already noted, there are right-sided and left-sided homonymous hemianopia.

right hand homonymous hemianopia occurs when the left optic tract is damaged. left-sided caused by damage to the right optic tract.

This pathological condition has another classification. Experts highlight:

Quadrant homonymous hemianopsia can be upper quadrant or lower quadrant, quadrant partial or quadrant complete.

There are also congenital homonymous hemianopia and developed as a consequence of a number of diseases.

Causes

The appearance of this visual defect is explained by pathology in the region of the visual tract, as well as the cerebral cortex.

Homonymous hemianopsia is a consequence of damage to the areas of the brain that should receive visual signals. The signals of the right and left eyes are transmitted along the optic nerves in such a way that problems in the left hemisphere of the brain cause the right half of the visual field to “darken out” in each eye, destructive processes in the right hemisphere are a factor that causes the left halves of the visual fields to fall out.

The problem may be due to congenital pathology. But it can also be caused by various diseases that affect the brain.

The most common cause of homonymous hemianopsia is the consequences of a stroke.. But also this condition can be explained by the presence of a tumor, an abscess, an inflammatory process, trauma or injury to the head area.

Homonymous hemianopia is caused by aneurysm of the artery of the base of the brain, circulatory problems in the region of the posterior and middle cerebral arteries, basal meningitis, meningoencephalitis.

All these conditions can cause the development of an inflammatory process, compression and impaired blood supply to the optic nerve fiber. Toxins also have a pathogenic effect on nerve fibers. After some time, under the influence of these factors, the visual tract is gradually destroyed.

Depending on what type of homonymous hemianopia is found in the patient, the specialist determines in which particular place the lesion is located. For example, lower quadrant homonymous hemianopsia develops in the case of problems that have arisen in the parietal lobe of the brain. The disease, localized in the temporal lobe, causes manifestations of complete upper quadrant hemianopsia.

Symptoms

Homonymous hemianopsia may sometimes not be noticeable to the patient. Homonymous hemianopsia does not affect visual acuity. Visual defects in some cases are detected only during the examination of the visual field. Manifestations of this type of hemianopsia are the loss of the temporal part of the visual field on the one hand, and the nasal part on the other. Sometimes half of the field of vision disappears completely (complete hemianopia). In some cases, "blackout" does not reach the periphery of the visual field (incomplete hemianopsia).

Cases have been observed in which the remaining half of the visual field slightly "overlaps" the blind side.

Homonymous hemianopia can make it difficult for a person to move. People, in some cases, encounter obstacles located on the side of the “dropped out” half of the field of view. It is almost impossible for the patient to drive a car, to distinguish between objects in the "blind zone" of the table. Visual defects make reading difficult: the reader cannot find a new line in the book. This kind of state can be unstable.

Sometimes a visual hallucination can become a symptom of homonymous hemianopsia. Especially often this violation manifests itself in cases where loss of part of the visual field develops after a stroke.

Possible Complications

Depending on a number of factors (the severity of the disease that provokes hemianopsia, the duration of the period of occurrence of disorders, the individual characteristics of the organism), a person suffering from hemianopia can either completely lose vision or restore it.

Diagnostics

You can determine the violation after studying the state of three important features of the work of the organs of vision:

The defect can be detected by examining the visual fields. The neurological technique includes an approximate check of the visual fields, which the doctor performs during the examination. A specialist can detect smaller problems of visual perception using conventional or computer perimetry.

To diagnose visual field defects in ophthalmology, visual field analyzer devices are used (for example, campimetry). Their use makes it possible to investigate the light and color sensitivity of the visual system. Devices are also used to investigate the flicker sensitivity of the visual analyzer.

The doctor can make the final diagnosis on the basis of obtaining a complete picture of the fundus, as well as associated neurological symptoms.

To determine the exact causes of a visual disorder, it is important to take an x-ray and a CT scan of the brain. The doctor may also order a more complete examination and a series of tests to help make a diagnosis.

Treatment

To get rid of the problems of visual perception, it is necessary to completely eliminate the consequences of the diseases that caused homonymous hemianopsia. If the treatment of the underlying disease is ineffective and untimely, then hemianopia can lead to complete loss of vision.

To eliminate neurological pathologies, surgical treatment, chemotherapy, and drug therapy are used, depending on the type and degree of complexity of the underlying problem.

Loss of visual fields in hemionopsia

Hemianopia is practically impossible to cure, however, after the elimination of the factor that causes it, a number of methods can be used to improve the patient's quality of life. For example, a person with homonymous hemianopia can learn to read by holding text at a 90° angle and reading it vertically.

Prevention

Prevention of the appearance of such problems with visual perception consists in conducting regular preventive examinations by a neurologist and an ophthalmologist. This will allow you to notice the beginning of the development of tumors in the cerebral cortex in time. Also, doctor's advice and supportive procedures can help avoid strokes. It is important to prevent the risk of injury to the skull area in every possible way.

Video

conclusions

Hemianopia is a defect in visual perception, in which the loss of half of the visual field develops in each eye. The cause of this condition is factors associated with damage to areas of the brain that should receive visual signals.

Treatment of hemianopsia is carried out depending on the nature of the underlying disease.

G emianopsia can be temporary or permanent. This is due to the severity of damage to the optic pathway.

With untimely or poor-quality treatment, pathological processes can lead to complete loss of vision, and, consequently, to disability.

Left and right homonymous eye hemianopia

Homonymous hemianopsia is a condition in which a person visualizes only the right or left half of the original visual fields. The line separating the visible and hidden side of the picture runs vertically right in the middle.

Heteronymous hemianopia also occurs. This is a type of visual loss in which the visible and the lost part of the visual field are separated horizontally. In some cases, not half, but a quarter falls out of sight. This pathology is called - quadrant hemianopsia.

Depending on which side the area “fell out”, both left-sided hemianopsia and right-sided hemianopsia can be observed.

Types of hemianopsia eyes

Not only a certain half of the field of view, but also a shapeless spot can “fall out” of the field of view. It can occur both unilaterally and bilaterally. Unilateral scotoma affects one eye, and bilateral scotoma, respectively, two.

Bilateral blind spot (scotoma) can be of the same name (the focus is located above the optic nerve junction) and opposite (the focus is located in the area of the optic nerve junction).

When parts of the visual field fall out, the pathology can have the following names:

left-sided homonymous hemianopsia (the left half of the visual field falls out);
upper quadrant hemianopsia (prolapse of the upper quarter);
right-sided homonymous hemianopsia (prolapse of areas on the right);
lower quadrant hemianopsia (prolapse of a quarter in the lower part).

By the presence of blind areas, complete hemianopsia (blind zone is exactly half) and partial can be observed.

Manifestations of hemianopsia

The disease is manifested by a violation of visual perception, which is accompanied by:

pain syndrome in the head;
fainting states;
increased photosensitivity;
impaired mobility of the arms or legs.

Concomitant symptomatic manifestations depending on the factor that provoked the loss of vision. The loss of fields depends on what types of hemianopia occur.

"Loss" of visual fields can have a different character. Lack of visibility in the halves from the side of the temporal zone is called - bitemporal hemianopsia, and "loss" of visibility in the region of the bridge of the nose is called - binasal hemianopsia.

There is also a disorder in which one eye loses vision from the side of the temple, and the other from the side of the nose. This type of ailment is called - contralateral homonymous hemianopia.

The causes of hemianopsia can be either permanent or intermittent.

What causes vision loss

Loss of vision is most often provoked by serious diseases, such as:

Dropsy of the brain (hydrocephalus). During this disease, excess fluid accumulates in the brain. The pressure of this fluid on the brain tissue leads to various anomalies, including visual impairment. The disease can be both congenital and acquired. The acquired form of the disease occurs as a result of a severe course of influenza, encephalitis, kidney or liver failure.
Migraine. During a migraine attack, visual disturbances may occur. This is due to a violation of blood flow in the optic nerve. The disease begins its development with symptoms such as increased hearing, photosensitivity and smell. The attack itself occurs due to abnormal expansion of blood vessels in the brain. During an attack, nausea and vomiting may occur. Loss of visual fields occur in those areas in which there is a violation of blood flow.
epileptic seizures. Epilepsy leads to swelling of the brain, as a result of which there is a violation of visual perception. Before an attack, the same manifestations that occur before a migraine attack may develop. Partial blindness can be both a consequence of the attack itself and a consequence of the hemorrhage that provoked the attack.
nephrotic syndrome.
Benign and malignant neoplasms in the brain. Education in the area of areas responsible for vision, lead to tissue compression, which in turn provokes loss of visual fields.
Traumatic brain injury. Damage often leads to the development of a hematoma in the brain. The hematoma presses on the tissues responsible for vision, as a result of which partial blindness is observed.
Violation of blood flow in the brain.
Serious poisoning of the body. Intoxication provoked by methyl alcohol or certain drugs leads to a violation of the quality of vision.
Pathologies of the central nervous system.

Anomalies of the occipital centers responsible for vision can also lead to such a problem. At the same time, even the defeat of that area of the brain, which at first glance has nothing to do with vision, can lead to partial blindness.

Establishing diagnosis

The diagnosis is established after the examination, during which the following is determined:

visual acuity;
line of sight;
ophthalmoscopy.

Based on the results of the examination, it is not always possible to establish an accurate diagnosis. This is because at the initial stages of the development of the disease there are no changes in the fundus. Pathological processes become noticeable, as a rule, after 12 months after the first signs of impaired visual fields.

In the first time after the onset of pathology, visual impairment is not observed. But in the absence of the necessary therapy, the disease very quickly leads to a serious deterioration in the quality of vision.

If a patient has been identified with right-sided or left-sided homonymous hemianopsia, immediate cause determination and treatment should be carried out.

Instrumental diagnostics is used to clarify and confirm the diagnosis. The patient is examined by:

computed tomography;
carotid angiography;
x-ray examination;
ultrasound examination;
magnetic resonance imaging of the brain.

If it is determined that the cause of vision loss is a tumor, a laboratory test is carried out to determine the amount of certain hormones.

To clearly identify areas that have fallen out of sight, specialists conduct perimetry.

Also, specialists conduct an examination, for which special devices are not required. Only a person with good vision is able to complete all stages of the examination. The survey is carried out as follows.

The specialist and the patient stand opposite each other at a distance of 1 meter. The eyes of both people should be at the same level.
One eye of both is closed with a special, light-tight bandage.
The subject must look into the doctor's open eye.
The specialist moves his finger at the same distance from himself and the patient. First, the finger is on the periphery, then gradually approaches closer to the center. As soon as the patient fixes the doctor's hand in the field of view, he must report this.
If the indicator of the vision of the specialist and the patient are the same, then the second one has no vision problems. If the indicators diverge, this indicates a violation in the patient's health.

This method of diagnosis gives good results only in the advanced form of the disease, since at the initial stages vision problems may be less pronounced.

Eye hemianopia treatment

Treatment of hemianopsia should be carried out taking into account the pathogenic factor that provoked such deviations. The first thing to do is fix the problem.

Sumatriptan nasal spray can be used to treat blindness caused by migraine. The name of one of the medicines is Immigrant.
If there is an excessive amount of fluid in the cavities of the brain, diuretic drugs are prescribed. Their use reduces the amount of pathological fluid in the brain.
If the loss of vision is provoked by a stroke, then after the examination, the specialist prescribes restorative therapy. As a rule, medicines are used that restore blood circulation and accelerate tissue regeneration. If there is a hemorrhagic stroke with high blood pressure, drugs are prescribed to optimize pressure. In the presence of ischemic stroke, the elimination of blood clots in the vessels of the brain is required. To do this, in the first hours after the attack, medications of fibrinolytic enzymes are prescribed.
During the rehabilitation period for a stroke, pharmacological agents are used to restore cerebral circulation.
If cancer is the cause of vision loss, chemotherapy or radiation therapy is required. But in some cases radical surgery is indicated.
Pathology provoked by injuries requires surgical intervention. In rare cases, drug therapy helps.

The considered type of vision pathology is evidence of serious abnormal changes in the human body. If even minor manifestations are detected, you should immediately visit a specialist to prevent the progression of the disease.

recovery forecasts

After treatment of the disease, both a complete restoration of the quality of vision and the acquisition of complete blindness (disability) can be observed. The result depends on the following factors:

the severity of the course of the disease that provoked the loss of vision;
method of therapy;
the duration of the presence of impaired visual perception;
the time of initiation of therapy, the earlier treatment is started, the greater the chance of a favorable outcome;
individual health status of the patient;
patient's age;
existing complications.

Impaired visual perception due to a stroke is restored in a period of up to one year.

Preventive actions

Preventive measures imply a systematic visit to an ophthalmologist and neuropathologist. Since most of the hemianopsias are provoked by cancerous tumors in the brain, it is necessary not to neglect scheduled visits to specialists. This is necessary for the timely identification of the problem.

In order to minimize the risk of developing the disease in question, it is necessary to carefully monitor your health and prevent injury to the head and neck. You should be attentive to the state of the cardiovascular system and conduct systematic examinations with a cardiologist.

If you notice unpleasant symptoms of any nature, you should immediately see a doctor. This will ensure timely diagnosis, and hence timely treatment. This will help eliminate the problem at the very beginning and prevent the development of possible complications.

Depending on which side the area “fell out”, both left-sided hemianopsia and right-sided hemianopsia can be observed.

Bilateral blind spot (scotoma) can be of the same name (the focus is located above the optic nerve junction) and opposite (the focus is located in the area of the optic nerve junction).

When parts of the visual field fall out, the pathology can have the following names:

left-sided homonymous hemianopsia (the left half of the visual field falls out);
upper quadrant hemianopsia (prolapse of the upper quarter);
right-sided homonymous hemianopsia (prolapse of areas on the right);
lower quadrant hemianopsia (prolapse of a quarter in the lower part).

By the presence of blind areas, complete hemianopsia (blind zone is exactly half) and partial can be observed.

Manifestations of hemianopsia

The disease is manifested by a violation of visual perception, which is accompanied by:

pain syndrome in the head;
fainting states;
increased photosensitivity;
impaired mobility of the arms or legs.

Concomitant symptomatic manifestations depending on the factor that provoked the loss of vision. The loss of fields depends on what types of hemianopia occur.

There is also a disorder in which one eye loses vision from the side of the temple, and the other from the side of the nose. This type of disease is called contralateral homonymous hemianopia.

The causes of hemianopsia can be either permanent or intermittent.

What causes vision loss

Loss of vision is most often provoked by serious diseases, such as:

Dropsy of the brain (hydrocephalus). During this disease, excess fluid accumulates in the brain. The pressure of this fluid on the brain tissue leads to various anomalies, including visual impairment. The disease can be both congenital and acquired. The acquired form of the disease occurs as a result of a severe course of influenza, encephalitis, kidney or liver failure.
Migraine. During a migraine attack, visual disturbances may occur. This is due to a violation of blood flow in the optic nerve. The disease begins its development with symptoms such as increased hearing, photosensitivity and smell. The attack itself occurs due to abnormal expansion of blood vessels in the brain. During an attack, nausea and vomiting may occur. Loss of visual fields occur in those areas in which there is a violation of blood flow.
epileptic seizures. Epilepsy leads to swelling of the brain, as a result of which there is a violation of visual perception. Before an attack, the same manifestations that occur before a migraine attack may develop. Partial blindness can be both a consequence of the attack itself and a consequence of the hemorrhage that provoked the attack.
nephrotic syndrome.
Benign and malignant neoplasms in the brain. Education in the area of areas responsible for vision, lead to tissue compression, which in turn provokes loss of visual fields.
Traumatic brain injury. Damage often leads to the development of a hematoma in the brain. The hematoma presses on the tissues responsible for vision, as a result of which partial blindness is observed.
Violation of blood flow in the brain.
Serious poisoning of the body. Intoxication provoked by methyl alcohol or certain drugs leads to a violation of the quality of vision.
Pathologies of the central nervous system.

Establishing diagnosis

The diagnosis is established after the examination, during which the following is determined:

visual acuity;
line of sight;
ophthalmoscopy.

If a patient has been identified with right-sided or left-sided homonymous hemianopsia, immediate cause determination and treatment should be carried out.

Instrumental diagnostics is used to clarify and confirm the diagnosis. The patient is examined by:

computed tomography;
carotid angiography;
x-ray examination;
ultrasound examination;
magnetic resonance imaging of the brain.

If it is determined that the cause of vision loss is a tumor, a laboratory test is carried out to determine the amount of certain hormones.

To clearly identify areas that have fallen out of sight, specialists conduct perimetry.

The specialist and the patient stand opposite each other at a distance of 1 meter. The eyes of both people should be at the same level.
One eye of both is closed with a special, light-tight bandage.
The subject must look into the doctor's open eye.
The specialist moves his finger at the same distance from himself and the patient. First, the finger is on the periphery, then gradually approaches closer to the center. As soon as the patient fixes the doctor's hand in the field of view, he must report this.
If the indicator of the vision of the specialist and the patient are the same, then the second one has no vision problems. If the indicators diverge, this indicates a violation in the patient's health.

This method of diagnosis gives good results only in the advanced form of the disease, since at the initial stages vision problems may be less pronounced.

Eye hemianopia treatment

Treatment of hemianopsia should be carried out taking into account the pathogenic factor that provoked such deviations. The first thing to do is fix the problem.

Sumatriptan nasal spray can be used to treat blindness caused by migraine. The name of one of the medicines is Immigrant.
If there is an excessive amount of fluid in the cavities of the brain, diuretic drugs are prescribed. Their use reduces the amount of pathological fluid in the brain.
If the loss of vision is provoked by a stroke, then after the examination, the specialist prescribes restorative therapy. As a rule, medicines are used that restore blood circulation and accelerate tissue regeneration. If there is a hemorrhagic stroke with high blood pressure, drugs are prescribed to optimize pressure. In the presence of ischemic stroke, the elimination of blood clots in the vessels of the brain is required. To do this, in the first hours after the attack, medications of fibrinolytic enzymes are prescribed.
During the rehabilitation period for a stroke, pharmacological agents are used to restore cerebral circulation.
If cancer is the cause of vision loss, chemotherapy or radiation therapy is required. But in some cases radical surgery is indicated.
Pathology provoked by injuries requires surgical intervention. In rare cases, drug therapy helps.

recovery forecasts

the severity of the course of the disease that provoked the loss of vision;
method of therapy;
the duration of the presence of impaired visual perception;
the time of initiation of therapy, the earlier treatment is started, the greater the chance of a favorable outcome;
individual health status of the patient;
patient's age;
existing complications.

Impaired visual perception due to a stroke is restored in a period of up to one year.

Preventive actions

To reduce the likelihood of developing various pathologies, you should carefully approach the choice of clinic. It is necessary that the organization could provide all the necessary services and examinations. The equipment of the clinic should be at the proper level. Also, one should not forget about the degree of qualification of specialists. Due attention and experience of specialists is the key to a healthy future.

The main types of hemianopsia differ in the root causes of their occurrence and the nature of the course. The appearance of a congenital or acquired form of the disease is due to damage to the visual system with loss of visual perception fields. Pathology covers the path from the place of interlacing of two chromatids to the spur groove. Lack of timely treatment of hemianopsia often leads to complete blindness.

12 main causes of pathological deviation

Damage that provokes the loss of part of the visual field is located in the brain, and not in the organs of the visual system. Therefore, complete hemianopia is basically a disease not of an ophthalmic nature, but of a neurological one.

The disease is formed when part of the visual pathways located between the spur groove and the intersection of the optic nerves (chiasm) is damaged. There are the following reasons for the formation of hemianopsia:

The risk of developing pathology increases in the presence of neurological diseases.

injury to the occipital lobe of the cerebral cortex or nerve fibers that conduct visual stimuli;
changes in the blood supply to brain tissue;
wounds and injuries of the skull;
damage to the visual tracts;
basal meningitis;
malignant tumors;
intracranial formations of a benign nature;
abscesses;
hypertensive crisis;
wrong tactics of doctors, especially during surgical operations;
ischemic infarction of the arteries of the brain;
congenital pathologies (microcephaly, hydrocephalus).

Types of the disease: characteristic features and manifestations

The type of hemianopsia depends on the site of injury and the degree of damage to the visual pathway - on the right or left. Therefore, people with such an ailment see only half of the image of various objects and objects. The table shows the types of deviation and their features:

Main manifestations

The perception of the surrounding world is disturbed, which can provoke a mental disorder.

Contralateral homonymous hemianopsia is accompanied by a loss of the ability to see the right or left half of the organ of vision. If the left optic tract is injured, functional disorders of the right-sided region of the eye develop, if the right one is damaged, the left parts of the visual perception field always fall out. If left-sided or right-sided homonymous hemianopsia is manifested due to brain injury, then paresthesia occurs, changes in pain and temperature sensations appear.

Binasal hemianopsia often causes visual hallucinations and disrupts the recognition of ordinary objects. For example, a person cannot recognize a familiar face. People with this pathology cannot perform any daily work, as many objects disappear from their visual perception.

Diagnostic measures

Basically, homonymous or heteronymous hemianopsia does not affect the clarity of vision and does not change the condition of the fundus. To make the correct diagnosis, determine the causes of the disease and the extent of the lesion, the following studies are carried out:

Perimetry. It reveals pathological changes in the angular space visible to the eye.
Computer campimetry. Examines the degree of change in light perception and color perception in injured or affected areas of the retina of the organ.
CT or MRI. They help to establish the etiology of the disease, reveal a cyst, a tumor, an abscess, an area of ischemia and traumatic brain damage.
Ultrasound of the vessels of the head. Allows you to determine the speed of blood flow in the eye and cerebral vessels, detects occlusions.
CT angiography. Gives an accurate image of the arteries of the brain, evaluates changes in blood flow.

Features of treatment

Therapy of any type of hemianopsia is based on the elimination of diseases that provoked the appearance of dropped visual fields.

Surgical intervention is required to treat the disease against the background of brain damage.

When the optic tract is damaged due to craniocerebral injuries, neurosurgical intervention is mainly required. In ischemic stroke, thrombolysis is performed in the first 5-6 hours to eliminate hemianopsia, then conservative treatment is used to reduce blood viscosity. Often, after a stroke, the patient sees worse with only one eye, so the functions of the visual system can be restored using medications and special exercises. Left-sided or right-sided hemianopsia, which is observed with damage to the vessels of the brain and the development of tumor processes, is treated surgically with the use of radiation and chemotherapy.

The congenital form of the disease is basically untreatable. A patient with such a pathology needs rehabilitation that ensures his connection and contact with the external environment. The rehabilitologist teaches the patient special eye movements towards the disappeared field of vision and exercises that help fix vision at various distances. Partially, and sometimes completely, the use of specific devices in the form of mirrors and prisms in glasses helps to normalize and improve the pathological deviation. They allow you to see blind areas when you shift your gaze to the dropped side.

If in these areas there is a decrease in visual function, then in this case we speak of relative blindness. When a person cannot distinguish colors in the visual fields, this condition is called hemichromatopsia.

Hemianopsia is right-sided and left-sided, with pathological changes in the right and left eyes, respectively, depending on the size of the invisible area, the pathology is divided into partial, complete and square.

Diagram of the visual pathway

Causes and mechanism of visual field loss

The disease can occur against the background of damage to the visual tracts, as well as the central parts of the visual pathways and sections of the cerebral cortex.

This is due to various reasons. Most often, the disease develops due to previously acquired pathologies. So, for example, with meningitis, squeezing of the areas that ensure the conduction of nerve impulses to the cerebral cortex occurs.

Pathology can also develop with various injuries and neoplasms in the brain. Another factor that provokes loss of visual fields is a violation of the blood circulation of the brain due to thromboembolism or aneurysm of cerebral vessels.

The performance of the visual pathways can be impaired due to increased pressure and an increase in the volume of circulating blood. Eventually, they may even atrophy.

If we talk about congenital blindness, then here the cause of the appearance of the disease lies in malformations, namely hydrocephalus, microcephaly, etc.

Consequence of neurological disorders

The disease most often develops as a result of damage to areas of the brain, as well as in various diseases of the neurological profile.

In order to find out the cause, as well as to determine the location of the lesion, a study is carried out - an MRI of the brain. Depending on the type and nature of brain damage, various types of hemianopia develop:

Homonymous hemianopsia develops due to circulatory disorders and damage to the cells of the hemispheres to which the posterior cerebral artery goes, often diagnosed with ischemic and hemorrhagic stroke.
Upper quadrant hemiopia occurs when the area of the cerebral cortex located below the spur groove in the temporo-occipital part is affected.
The reason for the appearance of the lower quadrant form of the disease is the lesion of the area of the cerebral cortex, which is located higher in relation to the spur groove.
More serious pathologies develop against the background of damage to the occipital lobes on both sides. As a result of this, visual hallucinations may even develop, the patient will not distinguish colors and will no longer recognize familiar people.

Sometimes the homonymous form of the disorder develops against the background of a heart attack that occurs in the areas to which the posterior cerebral artery goes.

Its borders with the middle cerebral artery can fluctuate. Often, the Sylvian furrow acts as such a conditional border. However, in some cases, the blood supply to the external parts of the occipital lobe occurs due to the middle cerebral artery.

Without giving specific examples, it is difficult to explain what patients experience when they develop this pathology. For example, patients diagnosed with right-sided homonymous hemianopsia will complain that they are unable to see with only their right eye. However, on examination, it is revealed that a person cannot see the right part of the visual field with the right and left eyes.

General symptoms

According to clinical manifestations, it is customary to separate homonymous and heteronymous hemianopia. In the first form of the disease, patients will say that they are unable to see with the right or left side of the eye.

With damage to the left and right visual tract, the patient's right and left eyes go blind, respectively.

With the development of the disease, the patient may experience visual hallucinations. This manifests itself in not recognizing familiar objects, the appearance of outbreaks, etc. Often, patients develop prosopagnosia, that is, the inability to recognize familiar people.

If patients remain oriented, they most often deny their disease. This condition indicates a positive Anton-Babinsky syndrome. Patients in this case can fix their eyes on only one object, and the surrounding objects will not enter their field of vision.

Most often, the first symptoms that indicate hemianopia appear after a person has had a stroke. Patients who begin to develop the disease mainly complain that their performance decreases, because it becomes much more difficult to perform any actions.

People face such problems: inability to find the right object, loss of orientation in space, difficulty eating, etc.

Classification and types of violation

Modern medicine distinguishes between several types and subspecies of hemianopsia.

The homonymous form is one of the most common forms

Homonymous anopsia is a pathological condition during the development of which the patient ceases to perceive the right or left area of the visual field.

Homonymous hemianopsia can be either right-sided or left-sided. It arises due to damage to the cortex of the occipital lobes, with the right side on the left, and with the left side on the right.

This pathology is also divided into complete, square and partial. The type of disease depends on which area is affected.

Additionally, this form of the disease is divided into congenital and acquired. Acquired homonymous hemianopsia occurs when the central nervous system and brain are damaged due to a stroke, traumatic brain injury, an unsuccessful operation, or a tumor.

All this leads to inflammation of the optic nerves. They are compressed, because of which blood circulation is disturbed, and toxins additionally have a negative effect on them. In this situation, dysfunction of the visual tracts develops.

Transient homonymous hemiopia is a pathology that is caused by diseases of the cerebral vessels. It is also called transient, because in this case there is a violation of blood circulation in the vessels of the brain.

In all the situations described, the focus of inflammation has a specific localization. Thus, if the parietal lobe is affected, then a person develops a lower square homonymous hemianopsia. Due to the defeat of the temporal region, the upper square or complete form of hemiopia develops.

Signs that indicate the appearance of this disease, in particular after a stroke or other brain damage, are primarily the occurrence of visual hallucinations.

Heteronymous form

Heteronymous hemianopsia is a pathology accompanied by a loss of perception of the nasal or temporal regions of the visual field. Here, too, there is a complete, partial and square form of the disease.

The bitemporal form is the most common

Bitemporal hemianopsia is characterized by the absence of visibility of the upper parts of the visual field in both eyes at once. This pathology occurs in patients more often than the previous two. It can lead to:

defeat of the pituitary part in the place where the optical fibers intersect;
damage to the medial part of the chiasm.

The localization of the blind area will depend on how much pressure is applied to the chiasm.

Binasal hemopia

Binasal hemianopsia is a disease that occurs with loss of visibility of the lower, in other words, nasal region of the visual field.

Heteronymous binasal blindness is a pathology accompanied by the appearance of several lesions at the same time, exerting pressure on the literal region of the chiasm.

The development of this form of the disorder is affected by chiasmal arachnoiditis, as well as the syndrome of an empty Turkish saddle.

The development of pathology in one eye with complete blindness of the second is a disease accompanied by a loss of visibility of a part of the visual field, which extends to only one eye, and the second becomes completely blind.

This pathology is divided into nasal and temporal. The difference of the latter lies in the fact that one eye becomes completely blind, and the second one has a loss of the upper half of the field of vision. This condition develops with complete damage to the optical fibers of the chiasm.

Nasal hemianopsia is rarely diagnosed. Its difference is that in this case the lower half of the field of view falls out.

This condition usually develops over a long period of time. First, there is partial blindness in both eyes at once. Later, it begins to progress and in case of incorrect therapy or in the absence of treatment, after some time, the left or right eye becomes completely blind.

Bilateral hemianopsia is a disease in which visibility disappears in both eyes at once. In this case, there are several lesions above the chiasm at once.

A scotoma is a dark area formed in the field of view. It comes in various forms. Scotoma has no connection with the peripheral borders, and therefore can manifest itself in absolutely any part of the field of view.

Diagnostic criteria

When complaints appear, the patient should undergo a series of studies, as well as visit specialists - an ophthalmologist and a neurologist.

For the diagnosis of the disease use:

CT - computed tomography;
UZGD - ultrasonic dopplerography of vessels;
MRI - magnetic resonance imaging, etc.

Only examinations will help to find out the exact cause of the development and nature of the disease.

Methods of treatment and prevention

Therapeutic measures for acquired hemianopia must necessarily be aimed at eliminating the cause of its occurrence.

If the injury or damage is severe, patients often require surgery. However, not all pathological conditions that affect vision can be treated.

Partially help glasses with special lenses

In this case, the patient should be prescribed rehabilitation, which will help make life easier and establish interaction in the external environment. For this, various exercises for the eyes are used, which the rehabilitation doctor must teach the patient.

Special mirrors, prisms, which are built into the patient's glasses, help to eliminate some manifestations of the disease. There are also computer techniques that improve visual functions and facilitate the orientation of the patient in space.

Possible consequences and complications directly depend on the form of the disease. Usually, if you make a diagnosis in time and start treatment, you can get rid of it completely.

But when the pathology that led to visual impairment progresses, the patient may eventually become completely blind.

Modern methods of rehabilitation cannot fully compensate for the symptoms of the disease, but they can make life easier for patients.

There are no effective preventive measures. To avoid problems and not start the disease, it is necessary to undergo a preventive examination once a year, and also consult a doctor immediately after the appearance of complaints.

Fatigue, dizziness, frequent headaches can indicate serious problems with the central nervous system.

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.

Hemianopia

Hemianopsia is bilateral blindness in a quarter or half of the visual field.

It is formed when the area of the visual pathways located between the chiasm and the spur groove is damaged. A feature of this area is the decussation of fibers, as a result of which nerves pass in the optical tracts not from one eye, but from the analogous halves of the retinas of two eyes. Depending on the location of the focus, different types of the disease are diagnosed.

The lesions that cause hemianopsia are located in the brain and not in the eyes. Therefore, such a pathology is not so much an ophthalmological problem as a neurological one.

Terminology

Hemianopsia with loss of one-sided (right or left) halves of the visual fields is called homonymous, versatile (temporal or nasal) - heteronymous. Loss of the temporal halves of the visual fields - bitemporal hemianopsia, nasal halves - binasal. In addition to the complete loss of half of the visual fields, depending on the location and size of the dropped areas, partial, quadrant, and scotoma hemianopsia is also observed. Hemianopsia with the spread of defects in two halves of the field of view is referred to as bilateral.

Classification

Hemianopsia is divided into several separate types, differing among themselves in the specifics of the course and the reasons for the appearance.

homonymous

Homonymous hemianopsia is a pathological condition in which a person perceives only one half (left or right) of the visual field, and the border separating the visible and dropped out halves passes through the central vertical meridian.

Right homonymous hemianopsia

Defects in both the optic tract and the cortex of the occipital lobe can lead to its appearance. Left-sided homonymous hemianopsia indicates the appearance of a focus on the right side of the above structures, and right-sided hemianopsia - on the left.

Homonymous hemianopsia has another classification, according to which it is divided into complete, quadrant, partial and scotoma. With complete homonymous hemianopia, the defect reaches the peripheral boundaries, occupying the entire half of the field of view, with partial, a more narrowed area falls out, and with quadrant, only the upper or lower quadrant (upper quadrant and lower quadrant hemianopsia, respectively). Quadrant homonymous hemianopsia is further divided into partial and complete.

Homonymous hemianopsia can be either congenital or appear after a stroke, neuroinfection, traumatic brain injury, gunshot wound, surgery, tumor. The occurrence of these defects leads to inflammation and compression of the fibers of the optic nerves, disruption of their blood supply, and pathogenic effects of toxins. Being in such an unnatural state for a long time, the visual tracts begin to atrophy.

Transient homonymous hemianopsia caused by vascular diseases is called transient, a sign of which is transient circulatory disorders in the cerebral vessels.

All of the above types of homonymous hemianopsia indicate a specific location of the focus. When the parietal lobe is affected, complete or lower quadrant homonymous hemianopsia is observed, the temporal lobe - complete or upper quadrant, the occipital lobe - contralateral homonymous hemianopsia.

A possible sign of the presence of this pathology, especially if it arose after a stroke, is the sudden onset of visual hallucinations - lights, geometric shapes, shapes, images of recognizable objects. Sometimes an object from the visible field of view is reflected in the blind. In most cases, such phenomena soon disappear as the brain adjusts to them.

Heteronymous

Heteronymous hemianopsia is a loss of perception of the temporal or nasal halves of the visual fields. The boundary separating the blind zone from the sighted runs along the central horizontal parallel. Like homonymous, this type of disease is further divided into complete, quadrant, partial and scotoma.

Bitemporal

Bitemporal hemianopsia involves the loss of the temporal (upper) halves of the visual field in two eyes at the same time. Diagnosed quite often.

Heteronymous bitemporal hemianopsia

Bitemporal hemianopsia is observed when:

areas of the pituitary gland, namely the places where the intersection of optical fibers occurs;
the area of the chiasma, namely its medial part.

The location of the blind area directly depends on the direction of pressure of the destructive focus on the chiasm:

Pressure from within - asymmetric bitemporal changes appear. The cause of the occurrence are gliomas of the chiasm and injuries leading to its tear.
Pressure from above - blindness occurs in the lower temporal quadrants. This type of pathology is most often associated with aneurysms (protrusion of the walls) of the anterior arteries.
Pressure from below - blindness appears in the upper temporal quadrants. The cause of the occurrence is endosellar tumors, which are characterized by the expansion of the lumen of the Turkish saddle and the expansion of its anterior and posterior walls.
Pressure behind - there is a bitemporal central scotoma. This pathology is associated with tumors of the pituitary stalk, as well as meningioma of the diaphragm of the Turkish saddle.
Pressure in front - diagnose complete bitemporal hemianopsia. Such types of pathology are associated with the appearance of neoplasms and meningiomas of the sphenoid sinus.

Binasal

Binasal hemianopsia is a pathological condition in which the perception of the nasal (lower) half of the visual field of both eyes is lost at the same time.

Heteronymous binasal hemianopsia

This type of disease implies the presence of two foci that put pressure on the chiasm, and specifically on its literal part. But according to some experts, binasal hemianopsia occurs when not the chiasm is damaged, but only the lateral portions of the optical fibers. In practice, this diagnosis is made very rarely. Binasal hemianopia occurs when the following lesions appear:

chiasmatic arachnoiditis (inflammation of the arachnoid mater);
hydrocephalus on the background of the tumor process;
Syndrome of "empty Turkish saddle".

These above diseases lead to compression of the chiasm.

Hemianopia in one eye with total blindness in the other

Hemianopsia in one eye with blindness in the other is a type of disease in which there is absolute blindness in one eye and partial in the other. There are two types: temporal and nasal.

Temporal hemianopsia occurs infrequently and manifests itself in the form of absolute blindness of one eye and loss of only the upper half on the other. The reason for its development is the complete defeat of all types of optical fibers of the chiasm of one eye.

Nasal hemianopsia is also rarely diagnosed and differs from temporal hemianopsia in that the lower half of the visual field falls out instead of the upper one. The reason for its appearance is associated with the development of two foci - the first on non-crossed fibers of one eye, and the second - on all retinal fibers of the other eye.

Such types of the disease occur gradually. Initially, either temporal or nasal hemianopia appear in two eyes, which progress in the absence of adequate treatment. Ultimately, one eye completely loses the ability to see.

bilateral

Bilateral hemianopsia is a type of disease in which defects are found in both visual fields. This kind of pathology occurs when one or two foci appear in the visual pathways above the chiasm, in the visual tracts, in the occipital lobe, both in one hemisphere and in two at the same time.

According to the nature of the changes, the disease is of two varieties:

with identical defects in half of the field of view. It is additionally divided into lower, upper, and also tubular (a narrow section is preserved in the center of the field of view);
with different defects in half of the field of view. This type includes various combinations, for example, hemianopic scotoma on one side and complete hemianopsia on the other.

scotoma

A scotoma (dark spot) is a blind spot in the visual field. It can take on different forms (circle, oval, ring, arc, blade) and form in any part of the visual field, since it is not associated with peripheral boundaries.

Central positive scotoma due to senile maculopathy

Patients perceive scotoma differently, and therefore it is further divided into the following types:

positive - perceived as a dark spot and appears when defects form on the vitreous body located in front of the retina;
negative - occurs against the background of defects in the visual pathway and is invisible to the patient.
atrial - manifested by flickering along the contour and occurs with ophthalmic migraine.

In addition to unilateral scotomas, bilateral (hemiscotomas) are also diagnosed. Depending on the location of the lesion, hemiscotomas are:

heteronymous (opposite) - the focus is located in the region of the chiasm;
homonymous (of the same name) - the focus is located above the chiasm.

According to the intensity of loss of visual function, scotomas are divided into two types:

absolute - visual function is completely lost;
relative - visual function is reduced to varying degrees.

Scotoma can be caused by:

pituitary tumors;
demyelinating diseases (destruction of the myelin sheath of neurons);
arterial hypertension, in pregnant women - preeclampsia;
prolonged exposure to toxic substances;
lack of nutrients;
migraine;
increased intracranial pressure;
the appearance of blood clots in the vessels of the retina.

Scotoma in most cases is obvious to a person, and therefore is diagnosed in the early stages of development. With atrial scotoma, in addition to pronounced visual defects, the patient has a violation of skin sensitivity, speech disorders, nausea, vomiting, migraine. In elderly patients, this condition may indicate not only the presence of hemianopsia, but also the approaching stroke.

Diagnostics

The diagnosis of hemianopsia can only be made after examining the status of three important elements:

The first two elements may not always indicate the presence of this particular disease. Examining the ophthalmological picture, a specialist may not notice pathological changes, since at the beginning of its course, the disease may not affect the condition of the fundus. Destructive changes in the visual pathways visible to the ophthalmologist, on average, appear only after a year.

The initial stages of the disease, as a rule, do not affect visual acuity. But in the absence of treatment and the transition of homonymous hemianopia to later stages, vision can deteriorate markedly due to the development of secondary atrophies that affect large areas of the optic nerves.

A more reliable sign is considered to be a hemianopsic pupillary reaction to light. But it will be objective only if the focus of pathology interrupts the arc of the pupillary reflex (tractus hemianopsia). If the focus is located above the arc, this symptom will not manifest itself in any way.

The study of the state of the visual fields is the main symptom on the basis of which the diagnosis of hemianopsia is made. To determine them, a test such as perimetry is used, which is based on the use of a perimeter device. The examination takes place in this way: the subject places his head on the chin of the device, covers one eye with a shutter, and fixes a bright point in the center of the arc with the other. This object is slowly moved from the periphery to the center along this arc, and the patient signals its appearance in the field of view, while denoting the boundaries of his field of vision.

More accurate results are obtained by computer perimetry, which consists in the use of automated devices.

If a patient has a homonymous or heteronymous hemianopia, the next step is to determine its type and the exact cause of its appearance. For this, methods such as ultrasound of the brain, computed tomography, carotid angiography, magnetic resonance imaging, and radiography are used. To determine the presence of neoplasms, endocrine pathologies are of great importance, to identify which a number of tests are carried out for the level of certain hormones.

Hemianopsia can be mistakenly equated with diseases such as hemihypopsia (deterioration of vision in certain areas) and hemichromatopsia (decrease in the perception of specific colors). These two pathologies can be either separate diseases or indicate the possible development of hemianopsia in the future.

Treatment

If left untreated, hemianopsia can progress rapidly and lead to complete loss of vision. Since the causes of occurrence are neurological pathologies and malignant tumors, the treatment regimen should be aimed at eliminating precisely these primary sources of the disease. To eliminate the causes of hemianopsia, surgical treatment, radiotherapy, and chemotherapy are used.

Almost all types of hemianopsia are not amenable to conservative treatment, but there are recommendations that can slightly improve the patient's quality of life. Reading can be made easier for the patient by consciously increasing the size of small eye movements to just one movement along a line of text. This can be achieved by holding the text at a 90° angle and reading vertically.

In right-sided homonymous hemianopia, the text must be rotated so that it can be read from top to bottom, while the next line of text must be in the preserved left visual field. Left-sided hemianopia also makes it difficult to read, and to simplify this task, the text must be rotated so that it can be read from bottom to top.

To facilitate movement in space, patients who are diagnosed with hemianopsia need to turn their eyes towards the blind side. When searching for objects located in the blind areas, instead of a series of small eye movements, it is necessary to consciously make large movements towards the blind field of vision, then returning to the object.

To improve the standard of living of a person suffering from hemianopia, his relatives and friends, who have taken it as a rule, can help:

When walking with the patient, always walk from the side of the hemianopia.
Always be in the visible half of the field of view.

There are computer techniques developed by specialists to improve the visual function of patients. According to scientists, the training course helps the patient to slightly compensate for the loss of the visual field and facilitates his orientation in space. The essence of these methods is to focus on the screen of a computer or mobile phone. Clinics offering this kind of service are located in many countries of the world.

Forecast

The prognosis for the restoration of vision after treatment ranges from its complete return to its absolute loss and depends on such factors:

the severity of the disease, against which the hemianopsia arose;
features of the treatment regimen;
duration of visual disturbances;
stage of the disease;
individual abilities of the patient's body;
the person's age;
presence of other complications.

The process of restoration of lost visual fields after a stroke has a favorable prognosis and in most cases reaches its maximum in the first six months.

Prevention

To prevent the onset of the disease, it is necessary to systematically be examined by an ophthalmologist and a neurologist. Since hemianopsia in most cases develops against the background of tumors in the brain, it is necessary to regularly undergo scheduled examinations for the presence of neoplasms.

Hemianopsia - what is it?

Hemianopsia is a visual impairment in which half of the field of view or a quarter of the field of vision falls out and the area of the field of vision that has fallen out can be located anywhere, depending on this, several types of hemianopsia are distinguished (the so-called quadrant hemianopsia, homonymous or heteronymous, binasal, bitemporal) . That is, a person does not see half of the visual picture, as shown in the figure at the beginning of the post. It is known that visual impairments occur in a variety of diseases, and, first of all, in eye diseases. The nature of these disorders is very diverse - from a decrease in visual acuity to the appearance of colored flashes or foreign objects, such as "lightning" or "flies" before the eyes.

Why are we talking about hemianopia? Causes.

Because this type of visual impairment causes damage to the nerve cells of the brain as a result of a pathological focus located in one of the visual lobes of the brain. It is in the visual lobes of the brain that the centers for analyzing and processing information coming from the retina of the eyeballs are located.

The causes of hemianopsia, as indicated above, lie in the brain - often after a stroke, brain injury, and can also occur with volumetric formations of the occipital lobe of the brain, so this type of visual impairment needs the same attention when restoring other disorders in the brain. rehabilitation practice and participate in its restoration should be a neurologist, occupational therapist, and an ophthalmologist is needed to confirm the neurological nature of visual impairment and control the restoration of the lost field of vision.

Ordinary household activities may carry the risk of injury. This danger is due to the loss of the usual orientation and coordination of actions. In the absence of visibility of half of the space, a person can easily fall, while maintaining the ability to move independently.

Since the cause of hemianopsia is the death of nerve cells responsible for the analysis and transmission in the form of visual perception of impulses, the first thing to do is to restore the affected tissue of the visual lobe. This process is long and not always as successful as one would like. The function of dead nerve cells is taken over by other "healthy" cells, it takes months, up to six months, at best, the field of vision is restored, often this is a longer period, sometimes lasting years.

In some cases, it is not possible to completely restore the lost field of vision. Thus, restorative treatment for hemianopsia is consistent with the principles of recovery for brain tissue damage such as stroke or traumatic brain injury and is not specific.

Left and right homonymous eye hemianopia

Depending on which side the area “fell out”, both left-sided hemianopsia and right-sided hemianopsia can be observed.

Types of hemianopsia eyes

Bilateral blind spot (scotoma) can be of the same name (the focus is located above the optic nerve junction) and opposite (the focus is located in the area of the optic nerve junction).

When parts of the visual field fall out, the pathology can have the following names:

left-sided homonymous hemianopsia (the left half of the visual field falls out);
upper quadrant hemianopsia (prolapse of the upper quarter);
right-sided homonymous hemianopsia (prolapse of areas on the right);
lower quadrant hemianopsia (prolapse of a quarter in the lower part).

By the presence of blind areas, complete hemianopsia (blind zone is exactly half) and partial can be observed.

Manifestations of hemianopsia

The disease is manifested by a violation of visual perception, which is accompanied by:

pain syndrome in the head;
fainting states;
increased photosensitivity;
impaired mobility of the arms or legs.

Concomitant symptomatic manifestations depending on the factor that provoked the loss of vision. The loss of fields depends on what types of hemianopia occur.

There is also a disorder in which one eye loses vision from the side of the temple, and the other from the side of the nose. This type of ailment is called - contralateral homonymous hemianopia.

The causes of hemianopsia can be either permanent or intermittent.

What causes vision loss

Loss of vision is most often provoked by serious diseases, such as:

Dropsy of the brain (hydrocephalus). During this disease, excess fluid accumulates in the brain. The pressure of this fluid on the brain tissue leads to various anomalies, including visual impairment. The disease can be both congenital and acquired. The acquired form of the disease occurs as a result of a severe course of influenza, encephalitis, kidney or liver failure.
Migraine. During a migraine attack, visual disturbances may occur. This is due to a violation of blood flow in the optic nerve. The disease begins its development with symptoms such as increased hearing, photosensitivity and smell. The attack itself occurs due to abnormal expansion of blood vessels in the brain. During an attack, nausea and vomiting may occur. Loss of visual fields occur in those areas in which there is a violation of blood flow.
epileptic seizures. Epilepsy leads to swelling of the brain, as a result of which there is a violation of visual perception. Before an attack, the same manifestations that occur before a migraine attack may develop. Partial blindness can be both a consequence of the attack itself and a consequence of the hemorrhage that provoked the attack.
nephrotic syndrome.
Benign and malignant neoplasms in the brain. Education in the area of areas responsible for vision, lead to tissue compression, which in turn provokes loss of visual fields.
Traumatic brain injury. Damage often leads to the development of a hematoma in the brain. The hematoma presses on the tissues responsible for vision, as a result of which partial blindness is observed.
Violation of blood flow in the brain.
Serious poisoning of the body. Intoxication provoked by methyl alcohol or certain drugs leads to a violation of the quality of vision.
Pathologies of the central nervous system.

Establishing diagnosis

The diagnosis is established after the examination, during which the following is determined:

If a patient has been identified with right-sided or left-sided homonymous hemianopsia, immediate cause determination and treatment should be carried out.

Instrumental diagnostics is used to clarify and confirm the diagnosis. The patient is examined by:

computed tomography;
carotid angiography;
x-ray examination;
ultrasound examination;
magnetic resonance imaging of the brain.

If it is determined that the cause of vision loss is a tumor, a laboratory test is carried out to determine the amount of certain hormones.

To clearly identify areas that have fallen out of sight, specialists conduct perimetry.

The specialist and the patient stand opposite each other at a distance of 1 meter. The eyes of both people should be at the same level.
One eye of both is closed with a special, light-tight bandage.
The subject must look into the doctor's open eye.
The specialist moves his finger at the same distance from himself and the patient. First, the finger is on the periphery, then gradually approaches closer to the center. As soon as the patient fixes the doctor's hand in the field of view, he must report this.
If the indicator of the vision of the specialist and the patient are the same, then the second one has no vision problems. If the indicators diverge, this indicates a violation in the patient's health.

This method of diagnosis gives good results only in the advanced form of the disease, since at the initial stages vision problems may be less pronounced.

Eye hemianopia treatment

Treatment of hemianopsia should be carried out taking into account the pathogenic factor that provoked such deviations. The first thing to do is fix the problem.

Sumatriptan nasal spray can be used to treat blindness caused by migraine. The name of one of the medicines is Immigrant.
If there is an excessive amount of fluid in the cavities of the brain, diuretic drugs are prescribed. Their use reduces the amount of pathological fluid in the brain.
If the loss of vision is provoked by a stroke, then after the examination, the specialist prescribes restorative therapy. As a rule, medicines are used that restore blood circulation and accelerate tissue regeneration. If there is a hemorrhagic stroke with high blood pressure, drugs are prescribed to optimize pressure. In the presence of ischemic stroke, the elimination of blood clots in the vessels of the brain is required. To do this, in the first hours after the attack, medications of fibrinolytic enzymes are prescribed.
During the rehabilitation period for a stroke, pharmacological agents are used to restore cerebral circulation.
If cancer is the cause of vision loss, chemotherapy or radiation therapy is required. But in some cases radical surgery is indicated.
Pathology provoked by injuries requires surgical intervention. In rare cases, drug therapy helps.

recovery forecasts

the severity of the course of the disease that provoked the loss of vision;
method of therapy;
the duration of the presence of impaired visual perception;
the time of initiation of therapy, the earlier treatment is started, the greater the chance of a favorable outcome;
individual health status of the patient;
patient's age;
existing complications.

Impaired visual perception due to a stroke is restored in a period of up to one year.

Causes

Varieties

Homonymous hemianopsia (homonymous hemianopsia)

Bitemporal heteronymous hemianopia

Upper quadrant hemianopsia

Lower quadrant hemianopsia

Clinical picture

Classification

How is the disease detected?

Treatment

Homonymous hemianopsia: types, methods of treatment, prevention

homonymous

Heteronymous

What diseases develop

Treatment

Forecast and prevention

Homonymous hemianopsia: causes and treatments

Types and classifications

Causes

Symptoms

Possible Complications

Diagnostics

Treatment

Prevention

Video

conclusions

Left and right homonymous eye hemianopia

Types of hemianopsia eyes

Manifestations of hemianopsia

What causes vision loss

Establishing diagnosis

Eye hemianopia treatment

recovery forecasts

Preventive actions

Manifestations of hemianopsia

What causes vision loss

Establishing diagnosis

Eye hemianopia treatment

recovery forecasts

Preventive actions

12 main causes of pathological deviation

Types of the disease: characteristic features and manifestations

Main manifestations

Diagnostic measures

Features of treatment

Causes and mechanism of visual field loss

Consequence of neurological disorders

General symptoms

Classification and types of violation

The homonymous form is one of the most common forms

Heteronymous form

The bitemporal form is the most common

Binasal hemopia

Diagnostic criteria

Methods of treatment and prevention

Hemianopia

Terminology

Classification

homonymous

Heteronymous

Bitemporal

Binasal

bilateral

scotoma

Diagnostics

Treatment

Forecast

Prevention

Hemianopsia - what is it?

Left and right homonymous eye hemianopia

Types of hemianopsia eyes

Manifestations of hemianopsia

What causes vision loss

Establishing diagnosis

Eye hemianopia treatment

recovery forecasts

Preventive actions

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