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Hemianopia

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The fact of having a reduction of the visual field implies strong repercussions in daily life since some daily activities such as reading, driving a vehicle, traveling in the street, among others, become a difficulty. Precisely, hemianopsia constitutes a disorder that manifests itself as the loss of the visual field and that can manifest itself in various ways and for different causes.

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What is hemianopia?

Hemianopia is an alteration of the sight that is characterized by a loss of half of the visual field , at the level of one eye, when it is a unilateral hemianopia or of both eyes, when it is bilateral . This problem usually affects the right or left half of the visual field or the upper or lower part.

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  • Types of hemianopsia
  •  Causes
  • Symptoms
  • Diagnosis
  • Treatment of hemianopia

Types of hemianopsia

  • Homonymous hemianopia: It can be right, due to loss of the right half of the visual field of each eye or left, due to a loss of the left half. This variety of hemianopia occurs due to a lesion of the visual pathways that are located after the optic chiasm. Low vision is instrumental in allowing doctors to locate the exact area of ​​the brain that has been affected.
  • Heteronymous hemianopia: Loss of vision occurs in different fields of the eyes. It is divided into two different categories:
  • Binasal hemianopia : It is a very rare condition. Loss of vision affects the interior of the visual field, in the nasal region, as if looking at the landscape with a pole in the middle of the face.
  • Bitemporal hemianopia: In this case, each eye has lost the outer half of the visual field.
  • Quadrantanopsia : Loss of vision that occurs in one quadrant or portion of the visual field. This will depend on the part of the brain that has been affected. The area that is connected to the part of the damaged brain portion will suffer hemianopia either partially or completely.
  • Superior hemianopia: Loss of vision occurs in the upper part of the visual field or in the right eye , the left eye , or both eyes.
  • Inferior hemianopia: Loss of vision occurs in the lower part of the visual field or in the right eye, the left eye, or both eyes.

 Causes

  • Causes of tumor origin:  the development of a tumor in the brain can compress the optic nerves and be the cause of a homonymous or heteronymous lateral hemianopia. Visual loss may, for example, be due to the development of a pituitary adenoma (benign non-cancerous tumor of the pituitary gland) of a meningioma (generally benign tumor that develops at the level of the meninges) or of a glioma (benign or malignant tumor that appears at glial tissue level.
  • Causes of vascular origin:  Homonymous lateral hemianopia can also be the consequence of a cerebrovascular accident (CVA). It should be remembered that a stroke is caused by a blood circulation disorder in the brain.
  • Traumatic Causes: In certain cases, nerve injury is caused by head trauma.

Symptoms

Hemianopia has a variety of symptoms that are associated with this visual condition, such as:

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  • Loss of peripheral vision in one or both eyes.
  • Loss of visual consciousness .
  • Inability to see objects or people on the side of the face where the hemianopia lesion takes place.
  • Inability to process entire sentences or words while reading due to interrupted or disturbed visual patterns.
  • Visual hallucinations regarding certain things such as light effects.

In addition to these physical indicators of hemianopia, there are also some psychological, emotional, cognitive, and even social repercussions . Some patients suffering from this pathology may fall into frustration or fear as their condition worsens since mobility or participation in social events can become extremely difficult. Furthermore, the patient will also have difficulty living independently.

Diagnosis

To carry out the diagnosis of hemianopsia, the optometrist will send the patient to a specialist who will perform a series of eye exams . It will begin by asking a series of questions in order to understand the symptoms suffered by the patient. In addition, a series of visual examinations are performed through a special machine called the Humphrey Field Analyzer that allows the depth of vision in each eye to be examined individually . After this evaluation, it is determined whether or not the patient has hemianopia. If so, the specialist will order a series of subsequent tests that will allow him to know the cause of the condition : brain damage, a blow or a tumor.

Treatment of hemianopia

Hemianopia must be treated as soon as possible to allow vision recovery and above all, to prevent the symptoms from worsening. This requires collaboration between different specialists: an ophthalmologist , a neurologist, an internist, and a radiologist . Recovery is generally a rare event if the cause is a severe stroke. Optical reeducation aims to help the patient to read and perceive the world around him.

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