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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.
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.
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.
The visual field of each eye can be divided in two vertically, with the outer half being described as temporal, and the inner half being described as nasal. "Bitemporal hemianopsia" can be broken down as follows: bi-: involves both left and right visual fields; temporal: involves the temporal visual field; hemi-: involves half of each visual field
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]
In children, optic disc drusen are usually buried and undetectable by fundoscopy except for a mild or moderate elevation of the optic disc. With age, the overlying axons become atrophied and the drusen become exposed and more visible. They may become apparent with an ophthalmoscope and some visual field loss at the end of adolescence. [7]
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