During the examination:

• Remember to describe the visual field as the patient sees it. Mention if the field defect is congruous (behind the lateral geniculate body) or incongruous (in the optic tract).
• Look for other neurological signs such as hemiplegia from cerebrovascular accident.

Additional examination (the followings are related to lesion in the parietal lobe):

• if the patient has a right inferior quadrinopia, mention that you would like to test the patient for Gertmann's syndrome. What is Gertmann's syndrome?


Answer
failure of patient's ability to calculate, name fingers and tell left from right (failure of these suggest Gertmann's syndrome which is seen in lesion of the dominant parietal lobe which is usually the left in right handed person)

 
in patient with hemianopia or inferior quadrinopia, mention you like to perform the optico-kinetic drum test for evidence of parietal lobe lesion. What abnormality may you see?

Answer
In parietal lobe lesion, there is impaired pursuit movement to the side of the lesion .

Normal opticokinetic nystagmus with  smooth pursuit movement.

Abnormal opticokinetic nystagmus with  small saccadic movement replacement the  smooth pursuit movement.

• which other higher sensory perceptions are impaired?

Answer
astereognosis (failure to tell an object through touch), joint position sense loss and loss of two point discrimination are seen in parietal lobe lesion
 
• test for sensory inattention. How do you test for sensory inattention?

Answer
by alternatively touching the patient's right then his left hand and then touching the two hand together (with patient's eyes closed). If the patient has sensory inattention, he would notice only one side being touched when you touch both his hands simultaneously.
 
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