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The visual pathway consists of structures that carry visual information from the retina to the brain.Lesions in that pathway cause a variety of visual field defects. In the visual system of human eye, the visual information processed by retinal photoreceptor cells travel in the following way:
Thus, if there is a question of papilledema on fundoscopic examination or if the optic disc cannot be adequately visualized, ultrasound can be used to rapidly assess for increased intracranial pressure and help direct further evaluation and intervention. Unilateral papilledema can suggest a disease in the eye itself, such as an optic nerve glioma.
Peripheral vision is usually spared since the pattern of loss typically involves a central or cecocentral scotoma, a visual field defect at or surrounding the point of fixation. This pattern can be revealed via visual field testing. Upon examination, the pupils usually demonstrate a normal response to light and near stimulation. In those who ...
For those with visual field defects optical coherence tomography has been recommended for follow-up of nerve fiber layer thickness. [12] Associated conditions such as angioid streaks and retinitis pigmentosa should be screened for. Both the severity of optic disc drusen and the degree of intraocular pressure elevation have been associated with ...
disc edema in the contralateral eye; central scotoma (loss of vision in the middle of the visual fields) in the ipsilateral eye; The presence of anosmia (loss of smell) ipsilateral to the eye demonstrating optic atrophy was historically associated with this syndrome, but is now understood to not strictly be associated with all cases. [4]
Visual acuity often remains stable and poor (around or below 20/200) with a residual central visual field defect. Patients with the 14484/ND6 mutation are most likely to have visual recovery. [8] Dominant optic atrophy is an autosomal dominant disease caused by a defect in the nuclear gene OPA1. A slowly progressive optic neuropathy, dominant ...
The visual field index (VFI) reflects retinal ganglion cell loss and function, as a percentage, with central points weighted more. [21] It is expressed as a percentage of visual function; with 100% being a perfect age-adjusted visual field and 0% represents a perimetrically blind field.
However, papillitis may be unilateral, whereas papilledema is almost always bilateral. Papillitis can be differentiated from papilledema by an afferent pupillary defect (Marcus Gunn pupil), by its greater effect in decreasing visual acuity and color vision, and by the presence of a central scotoma. Papilledema that is not yet chronic will not ...