 |
There
is bitemporal hemianopia which obeys the midline (the hemianopia may be
worse in one eye than the other or denser superiorly or inferiorly). This
suggests a lesion in the optic chiasm.
In the examination:
-
The hemianopia may be subtle and revealed only by comparing
two red objects in each hemifield. The red colour in the temporal field
appears washed out.
-
If the hemianopia does not obey midline consider pseudo-bitemporal
hemianopia such as bilateral sectorial retinitis pigmentosa, tilted discs
or bilateral inferotemopral retinoschisis. Mention that you would like
to examine the fundi for any such changes.
-
Features of pituitary abnormalities such as acromegaly, pan-hypopituitarism
(smooth skin and absence body hair in male)
-
Look for any scar suggestive of pituitary operation.
|