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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:
Figure 1 - Humphrey field analyser. Humphrey field analyser (HFA) is a tool for measuring the human visual field that is commonly used by optometrists, orthoptists and ophthalmologists, particularly for detecting monocular visual field. [1] The results of the analyser identify the type of vision defect.
According to Pollock et al. (2010) stroke is the main cause of specific visual impairment, most frequently visual field loss (homonymous hemianopia, a visual field defect). Nevertheless, evidence for the efficacy of cost-effective interventions aimed at these visual field defects is still inconsistent. [53]
As visual information exits the occipital lobe, and as sound leaves the phonological network, it follows two main pathways, or "streams". The ventral stream (also known as the "what pathway") leads to the temporal lobe, which is involved with object and visual identification and recognition .
Lesions in the pathway cause a variety of visual field defects. The type of field defect can help localize where the lesion is located (see figure). A lesion in the optic nerve of one eye causes partial or complete loss of vision in the same eye, with an intact field of vision in other eye.
The function of the feedback from the visual cortex back to the LGN is unknown. The optic radiation is activated during working memory tasks. [3] The optic radiations are usually unilateral and commonly vascular in origin. Field defects, therefore, develop abruptly, in contrast to the slow progression of defects associated with tumors.
It is a diagnostic tool that aids in the detection of visual disturbances caused by changes in the retina, particularly the macula (e.g. macular degeneration, Epiretinal membrane), as well as the optic nerve and the visual pathway to the brain. Amsler grid usually help detecting defects in central 20 degrees of the visual field. [2]
Macular sparing can be determined with visual field testing.The macula is defined as an area of approximately + 8 degrees around the center of the visual field. [3] During examination, vision in an area of greater than 3 degrees must be preserved for a patient to be considered to have macular sparing because there is involuntary eye movement within 1 to 2 degrees.