🧠 VISUAL FIELD DEFECTS
Localize the Lesion. Predict the Defect.
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1️⃣ Optic Nerve
➊ Pre-chiasmal lesion
➋ Ipsilateral monocular blindness
➌ Vision loss in one eye only
💡 Think: “One Nerve = One Eye”
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2️⃣ Optic Chiasm
➊ Compression of crossing nasal fibers
➋ Classically caused by pituitary adenoma
➌ Bitemporal hemianopia
💡 Think: “Can’t see the sides”
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3️⃣ Optic Tract
➊ Post-chiasmal lesion
➋ Contralateral homonymous hemianopia
➌ Same visual field lost in both eyes
💡 Think: “Tract = Opposite Side Lost”
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4️⃣ Temporal Lobe (Meyer’s Loop)
➊ Contralateral superior quadrantanopia
➋ Loss of upper visual field quadrant
➌ Temporal lobe lesion
💡 Think: “Pie in the Sky”
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5️⃣ Occipital Lobe
➊ Contralateral homonymous hemianopia
➋ Macular sparing often present
➌ PCA territory infarction is a classic cause
💡 Think: “Occipital = Opposite Field Lost”
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🎯 High-Yield Rules
✅ Nasal retinal fibers cross at the chiasm
✅ Temporal retinal fibers do NOT cross
✅ Post-chiasmal lesions cause contralateral defects
✅ Macular sparing suggests occipital lobe involvement
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🧠 Easy Mnemonic
N → C → T → L → O
👁️ Nerve → Monocular Blindness
✖️ Chiasm → Bitemporal Hemianopia
🔵 Tract → Homonymous Hemianopia
🥧 Loop (Meyer’s) → Pie in the Sky
🎯 Occipital → Homonymous Hemianopia Macular Sparing
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