MRCP revision on the go...: MRCP revision battle 27.

5: Visual field defects

11/13/11 11:03 PM

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MRCP revision on the go...

One busy junior doctor's battle with the MRCP exam/retaining her sanity.
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MRCP revision battle 27.5: Visual field defects

Visual fields pop up frequently in MRCP questions so it pays to learn this well! The basic anatomy is illustrated below:

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Marie Treasure UK junior doctor attempting to revise for MRCP whilst maintaining her sanity/free time for the things in life doctors know are actually luxuries, like sleeping and eating. No responsibility taken for any inaccuracies contained within, and please be aware that as this blog will often be written in a sleep/glucose deprived state the potential for whoopsies is great. If you want to email me with corrections/suggestions/offers of chocolate, please do so to: marietreasure7 (at) gmail.com View my complete profile

Armed this this anatomy lets look at the various patterns of field defect...
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caused by compression of the optic chiasm upper affected more than lower = due to pituitary tumour lower affected more than upper = due to craniopharyngioma

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MRCP revision on the go...: MRCP revision battle 27.5: Visual field defects

11/13/11 11:03 PM

I personally remember this as UP London City

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2: Homonymous quadrantanopia

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superior homonymous quadrantanopia is a lesion in the temporal lobe inferior homonymous quadrantanopia is a lesion in the parietal lobe this can be remembered by thinking PITS - parietal inferior temporal superior if the defect is incongruous it is in the optic tract if the defect is congruous it is in the optic radiation/cortex

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3: Homonymous hemianopia

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injury to the brain (eg bleed, tumour) on the opposite side to the field defect

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4: Central scotoma

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usually caused by optic neuritis

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MRCP revision on the go...: MRCP revision battle 27.5: Visual field defects

11/13/11 11:03 PM

rare ?calcification of carotids

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Note that the fovea is supplied by both the PCA and MCA so may be spared in a PCA CVA.

In the calcarine sulcus peripheral regions are processed anteriorly while central regions are processed posteriorly.

Finally remember cortical blindness: caused by bilateral occipital infarcts pupillary responses are preserved possibly small macular sparing patient may deny they have vision loss (=Anton's syndrome)

Wow, that was lots for one battle... lets move on to some urine for light relief...
Posted by Marie Treasure at 06:02 Recommend this on Google Labels: anton's syndrome, visual field defects

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