Makindo Medical Notes Comprehensive Medical Encyclopedia | Education for Healthcare Professionals

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Optics Pathway

**👁️ Figure 1-13: Common Visual Field Defects & Their Anatomic Bases**
Defect	Description	Anatomic Basis
🎯 Central Scotoma	Loss of central vision	Optic neuritis (MS), retrobulbar neuritis
🚫 Total Blindness (Right Eye)	Complete loss of vision in right eye	Complete lesion of right optic nerve
⏸️ Bitemporal Hemianopia	Loss of temporal fields in both eyes	Compression of optic chiasm (e.g. pituitary adenoma)
↔️ Right Nasal Hemianopia	Loss of nasal field in right eye	Perichiasmal lesion (e.g. calcified ICA)
🌓 Right Homonymous Hemianopia	Loss of right visual field in both eyes	Left optic tract lesion
🔼 Right Superior Quadrantanopia	Loss of upper right quadrant in both eyes	Left temporal lobe lesion (Meyer’s loop)
🔽 Right Inferior Quadrantanopia	Loss of lower right quadrant in both eyes	Left parietal lobe lesion
⬛ Right Homonymous Hemianopia	Loss of right visual field in both eyes	Complete left optic radiation lesion
🖼️ Right Homonymous Hemianopia (Macular Sparing)	Loss of right visual field, macula spared	Occipital cortex lesion (PCA infarct – macula spared due to MCA supply)

💡 Clinical Pearls

🎯 Central scotoma → Think MS or optic neuritis.
⏸️ Bitemporal hemianopia → Classic for pituitary adenoma compressing the chiasm.
🌓 Homonymous hemianopia → Contralateral optic tract or radiation lesion.
🔼 Superior quadrantanopia (“pie in the sky”) → Temporal lobe lesion.
🔽 Inferior quadrantanopia (“pie on the floor”) → Parietal lobe lesion.
🖼️ Macular sparing → Occipital cortex stroke (dual MCA/PCA supply).

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Makindo Medical Notes

Optics Pathway

💡 Clinical Pearls

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