Optic Nerve Clinical Notes and Interpretation

• The patient must have intact cognitive abilities and the ability to cooperate in order to successfully accomplish the previously described examination tasks.
• Visual acuity testing is typically performed with corrective lenses, if the patient commonly uses them, but can be performed without them.
• Differences of more than one line in visual acuity should be referred to an ophthalmologist.
• Macular degeneration, cataracts, and retinal disease may cause blind spots.
• An optic nerve lesion will produce complete or partial blindness in the involved eye.
• A complete lesion in one optic tract or in one lateral geniculate body results in blindness in opposite visual fields (i.e., nasal and temporal) of both eyes.
• A temporal lobe lesion may produce blindness in the upper quadrants of both visual fields contralateral to the lesion.
• A parietal lobe lesion may produce contralateral blindness in the lower quadrants of both eyes.
• Occipital lesions cause contralateral changes with macular sparing.
• Cortical blindness can also occur from occipital lesions, particularly to association areas.
• Pre-chiasmatic lesions result in ipsilateral loss of vision (i.e., retinal tumors, masses affecting the optic nerve).
• Chiasmic lesions result in bi-temporal hemianopsia (i.e., pituitary tumors, Berry aneurysm).
  

Point here to view typical visual field deficits