{"id":59,"date":"2024-06-28T17:44:30","date_gmt":"2024-06-28T21:44:30","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/vision\/?post_type=chapter&#038;p=59"},"modified":"2024-10-02T17:18:56","modified_gmt":"2024-10-02T21:18:56","slug":"visual-field-loss","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/vision\/chapter\/visual-field-loss\/","title":{"raw":"Visual Field Loss","rendered":"Visual Field Loss"},"content":{"raw":"<h2>What are visual fields?<\/h2>\r\n<p dir=\"ltr\">Visual fields are the whole area seen through the eyes and described as if you were standing behind the person. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK220\/figure\/A3545\/?report=objectonly\" target=\"_blank\" rel=\"noopener\">A typical visual field<\/a> (Spector, 1990) has the following parameters:<\/p>\r\n\r\n<ul>\r\n \t<li>90 degrees temporally from a central fixation point<\/li>\r\n \t<li>50 degrees superiorly and nasally (upper fields)<\/li>\r\n \t<li>60 degrees inferiorly and nasally (lower fields)<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_476\" align=\"aligncenter\" width=\"300\"]<img class=\"wp-image-476 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Normal_right_eye_visual_fild_by_campimeter-300x211.jpg\" alt=\"The normal right eye visual field is graphed in a series of circles\" width=\"300\" height=\"211\" \/> Normal right visual field. Pignol23, CC BY <span style=\"color: #000000\">3.0, via Wikimedia Commons<\/span>[\/caption]\r\n<h2 dir=\"ltr\">Causes of visual field loss<\/h2>\r\n<div>\r\n\r\nLoss of vision in part of the field of vision may be due to traumatic brain injury, tumor, surgery, or infarct in the posterior cerebral artery. Loss of part of the field of vision can also occur due to a genetic condition, glaucoma, or toxic exposures.\r\n<h2>Types of visual field loss<\/h2>\r\n<div>\r\n\r\nField loss can affect different parts of the field of vision depending on what part of the system is affected. Visual field loss can be central (e.g., in macular degeneration) or peripheral (e.g., \"tunnel vision\"), impact a quadrant (quadrantanopia), or affect half (hemianopia) of the visual fields. <span style=\"color: #000000\">Visual field loss can also be limited to the nasal half (towards the nose) or the temporal half (towards the temples) of the field of vision.<\/span>\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n\r\n[caption id=\"attachment_196\" align=\"aligncenter\" width=\"216\"]<img class=\"wp-image-196 size-full\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Human_eyesight_two_children_and_ball_with_retinitis_pigmentosa_or_tunnel_vision.png\" alt=\"Photo of two boy smiling. The whole photo is blacked out except for a relatively small circle showing part of the boys' faces\" width=\"216\" height=\"173\" \/> National Eye Institute, National Institutes of Health, Public domain, via Wikimedia Commons. Example of tunnel (peripheral vision loss)[\/caption]\r\n\r\n<div>\r\n\r\nHomonymous hemianopia is when the same half of the visual field is affected in both eyes. This occurs due to damage to the visual pathways, between the optic chiasm and the visual cortex, on the opposite side of the vision loss. Many children with homonymous hemianopia will also have weakness or paralysis on the same side of the body as the vision loss.\r\n\r\n&nbsp;\r\n\r\n[caption id=\"attachment_51\" align=\"aligncenter\" width=\"449\"]<img class=\"wp-image-51\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en-300x298.jpg\" alt=\"Schematic of visual fields and visual of 6 types of visual field defects\" width=\"449\" height=\"446\" \/> Image attribution: As eo, CC BY-SA 4.0, via Wikimedia Commons[\/caption]\r\n<p id=\"yui_3_17_2_1_1719610068973_76\" dir=\"ltr\">1. Complete loss of vision right eye\r\n2.\u00a0Bitemporal hemianopia\r\n3. Left homonymous hemianopsia\r\n4. Upper left quadrantanopia\r\n5&amp;6. Quadrantanopia with macular sparing<\/p>\r\n<p dir=\"ltr\"><\/p>\r\n\r\n<\/div>\r\n<div>The picture below shows what someone with a complete right homonymous hemianopia would see:<\/div>\r\n<div>\r\n<div><\/div>\r\n\r\n[caption id=\"attachment_60\" align=\"aligncenter\" width=\"403\"]<img class=\"wp-image-60\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-300x151.png\" alt=\"two circles showing a view overhead of a city. The right half of each circle is missing showing the loss of visual field in the right hemi-field of each eye\" width=\"403\" height=\"203\" \/> Image attribution: Nunh-huh at English Wikipedia, via Wikimedia Commons,\u00a0CC BY-SA 3.0[\/caption]\r\n\r\n<\/div>\r\n<div>\r\n<div>\r\n<h2>Visual field loss and reading<\/h2>\r\n<\/div>\r\n<span style=\"color: #000000\">Central vision is essential for reading as there is a high density of cones in the center (fovea) of the retina. This high acuity vision allows the reader to clearly see about four to five letters at a time in optimally sharp focus. The parafovea, the around the fovea, gives the reader a \"big picture\" of the scene, allowing a preview of upcoming words. When reading text from left to right, the \"perceptual span\" (or area viewable with parafoveal vision) - extends about three to four letters or spaces to the left and up to 15 letters or spaces to the right. This span allows the reader to plan where to fixate the eyes next along the line of text. <\/span>\r\n\r\n<\/div>\r\n<span style=\"color: #000000\">With longer words, the reader with homonymous hemianopia can only see part of the word, which can lead to guessing the beginning or ending of a word. In addition, with the loss of the right visual field, the reader misses out on having a large perceptual span to the right and must spend extra time scanning text to find the next fixation spot. Reading with right-sided homonymous hemianopia is described as \"reading into nothingness.\" Left-sided homonymous hemianopia can lead to difficulty keeping place between lines (Lawrence et al., 2018).<\/span>\r\n\r\nTo learn more about visual field loss and its impact on reading, please see\u00a0 <em><a href=\"https:\/\/epilepsysurgeryalliance.org\/wp-content\/uploads\/2017\/06\/FINAL-Vision-After-Hemispherectomy-TPO-Disconnection-and-Occipital-Lobectomy.pdf\">Vision After Hemispherectomy, TPO Disconnection, and Occipital Lobectomy: An Introductory Guide<\/a> <\/em>(Lawrence et al., 2018).\r\n<div>\r\n<div>\r\n<h2>References<\/h2>\r\n<p class=\"hanging-indent\">Lawrence, L., Jones, M., &amp; Vernick, A. (2018). <em>Vision after hemispherectomy, TPO disconnection, and occipital lobectomy: An introductory guide<\/em>. The Brain Recovery Project: Childhood Epilepsy Surgery Foundation. <a href=\"https:\/\/epilepsysurgeryalliance.org\/wp-content\/uploads\/2017\/06\/FINAL-Vision-After-Hemispherectomy-TPO-Disconnection-and-Occipital-Lobectomy.pdf\">https:\/\/epilepsysurgeryalliance.org\/wp-content\/uploads\/2017\/06\/FINAL-Vision-After-Hemispherectomy-TPO-Disconnection-and-Occipital-Lobectomy.pdf<\/a><\/p>\r\n<p class=\"hanging-indent\">Spector, R. H. (1990).\u00a0Visual fields. In H. K. Walker, W. D. Hall, &amp; J. W. Hurst (Eds),\u00a0<em>Clinical methods: The history, physical, and laboratory examinations <\/em>(3rd ed., Figure 116.1). <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK220\/figure\/A3545\/?report=objectonly\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK220\/figure\/A3545\/?report=objectonly<\/a><\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>","rendered":"<h2>What are visual fields?<\/h2>\n<p dir=\"ltr\">Visual fields are the whole area seen through the eyes and described as if you were standing behind the person. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK220\/figure\/A3545\/?report=objectonly\" target=\"_blank\" rel=\"noopener\">A typical visual field<\/a> (Spector, 1990) has the following parameters:<\/p>\n<ul>\n<li>90 degrees temporally from a central fixation point<\/li>\n<li>50 degrees superiorly and nasally (upper fields)<\/li>\n<li>60 degrees inferiorly and nasally (lower fields)<\/li>\n<\/ul>\n<figure id=\"attachment_476\" aria-describedby=\"caption-attachment-476\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-476 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Normal_right_eye_visual_fild_by_campimeter-300x211.jpg\" alt=\"The normal right eye visual field is graphed in a series of circles\" width=\"300\" height=\"211\" srcset=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Normal_right_eye_visual_fild_by_campimeter-300x211.jpg 300w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Normal_right_eye_visual_fild_by_campimeter-65x46.jpg 65w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Normal_right_eye_visual_fild_by_campimeter-225x159.jpg 225w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Normal_right_eye_visual_fild_by_campimeter-350x247.jpg 350w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Normal_right_eye_visual_fild_by_campimeter.jpg 640w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-476\" class=\"wp-caption-text\">Normal right visual field. Pignol23, CC BY <span style=\"color: #000000\">3.0, via Wikimedia Commons<\/span><\/figcaption><\/figure>\n<h2 dir=\"ltr\">Causes of visual field loss<\/h2>\n<div>\n<p>Loss of vision in part of the field of vision may be due to traumatic brain injury, tumor, surgery, or infarct in the posterior cerebral artery. Loss of part of the field of vision can also occur due to a genetic condition, glaucoma, or toxic exposures.<\/p>\n<h2>Types of visual field loss<\/h2>\n<div>\n<p>Field loss can affect different parts of the field of vision depending on what part of the system is affected. Visual field loss can be central (e.g., in macular degeneration) or peripheral (e.g., &#8220;tunnel vision&#8221;), impact a quadrant (quadrantanopia), or affect half (hemianopia) of the visual fields. <span style=\"color: #000000\">Visual field loss can also be limited to the nasal half (towards the nose) or the temporal half (towards the temples) of the field of vision.<\/span><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<figure id=\"attachment_196\" aria-describedby=\"caption-attachment-196\" style=\"width: 216px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-196 size-full\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Human_eyesight_two_children_and_ball_with_retinitis_pigmentosa_or_tunnel_vision.png\" alt=\"Photo of two boy smiling. The whole photo is blacked out except for a relatively small circle showing part of the boys' faces\" width=\"216\" height=\"173\" srcset=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Human_eyesight_two_children_and_ball_with_retinitis_pigmentosa_or_tunnel_vision.png 216w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Human_eyesight_two_children_and_ball_with_retinitis_pigmentosa_or_tunnel_vision-65x52.png 65w\" sizes=\"auto, (max-width: 216px) 100vw, 216px\" \/><figcaption id=\"caption-attachment-196\" class=\"wp-caption-text\">National Eye Institute, National Institutes of Health, Public domain, via Wikimedia Commons. Example of tunnel (peripheral vision loss)<\/figcaption><\/figure>\n<div>\n<p>Homonymous hemianopia is when the same half of the visual field is affected in both eyes. This occurs due to damage to the visual pathways, between the optic chiasm and the visual cortex, on the opposite side of the vision loss. Many children with homonymous hemianopia will also have weakness or paralysis on the same side of the body as the vision loss.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_51\" aria-describedby=\"caption-attachment-51\" style=\"width: 449px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-51\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en-300x298.jpg\" alt=\"Schematic of visual fields and visual of 6 types of visual field defects\" width=\"449\" height=\"446\" srcset=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en-300x298.jpg 300w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en-150x150.jpg 150w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en-65x65.jpg 65w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en-225x224.jpg 225w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en-350x348.jpg 350w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/Hemianopsia_en.jpg 604w\" sizes=\"auto, (max-width: 449px) 100vw, 449px\" \/><figcaption id=\"caption-attachment-51\" class=\"wp-caption-text\">Image attribution: As eo, CC BY-SA 4.0, via Wikimedia Commons<\/figcaption><\/figure>\n<p id=\"yui_3_17_2_1_1719610068973_76\" dir=\"ltr\">1. Complete loss of vision right eye<br \/>\n2.\u00a0Bitemporal hemianopia<br \/>\n3. Left homonymous hemianopsia<br \/>\n4. Upper left quadrantanopia<br \/>\n5&amp;6. Quadrantanopia with macular sparing<\/p>\n<p dir=\"ltr\">\n<\/div>\n<div>The picture below shows what someone with a complete right homonymous hemianopia would see:<\/div>\n<div>\n<div><\/div>\n<figure id=\"attachment_60\" aria-describedby=\"caption-attachment-60\" style=\"width: 403px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-60\" src=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-300x151.png\" alt=\"two circles showing a view overhead of a city. The right half of each circle is missing showing the loss of visual field in the right hemi-field of each eye\" width=\"403\" height=\"203\" srcset=\"https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-300x151.png 300w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-1024x515.png 1024w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-768x386.png 768w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-65x33.png 65w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-225x113.png 225w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss-350x176.png 350w, https:\/\/pressbooks.bccampus.ca\/vision\/wp-content\/uploads\/sites\/2241\/2024\/06\/visual-field-loss.png 1183w\" sizes=\"auto, (max-width: 403px) 100vw, 403px\" \/><figcaption id=\"caption-attachment-60\" class=\"wp-caption-text\">Image attribution: Nunh-huh at English Wikipedia, via Wikimedia Commons,\u00a0CC BY-SA 3.0<\/figcaption><\/figure>\n<\/div>\n<div>\n<div>\n<h2>Visual field loss and reading<\/h2>\n<\/div>\n<p><span style=\"color: #000000\">Central vision is essential for reading as there is a high density of cones in the center (fovea) of the retina. This high acuity vision allows the reader to clearly see about four to five letters at a time in optimally sharp focus. The parafovea, the around the fovea, gives the reader a &#8220;big picture&#8221; of the scene, allowing a preview of upcoming words. When reading text from left to right, the &#8220;perceptual span&#8221; (or area viewable with parafoveal vision) &#8211; extends about three to four letters or spaces to the left and up to 15 letters or spaces to the right. This span allows the reader to plan where to fixate the eyes next along the line of text. <\/span><\/p>\n<\/div>\n<p><span style=\"color: #000000\">With longer words, the reader with homonymous hemianopia can only see part of the word, which can lead to guessing the beginning or ending of a word. In addition, with the loss of the right visual field, the reader misses out on having a large perceptual span to the right and must spend extra time scanning text to find the next fixation spot. Reading with right-sided homonymous hemianopia is described as &#8220;reading into nothingness.&#8221; Left-sided homonymous hemianopia can lead to difficulty keeping place between lines (Lawrence et al., 2018).<\/span><\/p>\n<p>To learn more about visual field loss and its impact on reading, please see\u00a0 <em><a href=\"https:\/\/epilepsysurgeryalliance.org\/wp-content\/uploads\/2017\/06\/FINAL-Vision-After-Hemispherectomy-TPO-Disconnection-and-Occipital-Lobectomy.pdf\">Vision After Hemispherectomy, TPO Disconnection, and Occipital Lobectomy: An Introductory Guide<\/a> <\/em>(Lawrence et al., 2018).<\/p>\n<div>\n<div>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Lawrence, L., Jones, M., &amp; Vernick, A. (2018). <em>Vision after hemispherectomy, TPO disconnection, and occipital lobectomy: An introductory guide<\/em>. The Brain Recovery Project: Childhood Epilepsy Surgery Foundation. <a href=\"https:\/\/epilepsysurgeryalliance.org\/wp-content\/uploads\/2017\/06\/FINAL-Vision-After-Hemispherectomy-TPO-Disconnection-and-Occipital-Lobectomy.pdf\">https:\/\/epilepsysurgeryalliance.org\/wp-content\/uploads\/2017\/06\/FINAL-Vision-After-Hemispherectomy-TPO-Disconnection-and-Occipital-Lobectomy.pdf<\/a><\/p>\n<p class=\"hanging-indent\">Spector, R. H. (1990).\u00a0Visual fields. In H. K. Walker, W. D. Hall, &amp; J. W. Hurst (Eds),\u00a0<em>Clinical methods: The history, physical, and laboratory examinations <\/em>(3rd ed., Figure 116.1). <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK220\/figure\/A3545\/?report=objectonly\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK220\/figure\/A3545\/?report=objectonly<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"author":620,"menu_order":6,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-59","chapter","type-chapter","status-publish","hentry"],"part":138,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/pressbooks\/v2\/chapters\/59","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/wp\/v2\/users\/620"}],"version-history":[{"count":25,"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/pressbooks\/v2\/chapters\/59\/revisions"}],"predecessor-version":[{"id":1116,"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/pressbooks\/v2\/chapters\/59\/revisions\/1116"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/pressbooks\/v2\/parts\/138"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/pressbooks\/v2\/chapters\/59\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/wp\/v2\/media?parent=59"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/pressbooks\/v2\/chapter-type?post=59"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/wp\/v2\/contributor?post=59"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/vision\/wp-json\/wp\/v2\/license?post=59"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}