Temporal Crescent

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90° Visual field

• Fatigue, poor concentration, cannot understand the task of divided attention

• Functional/malingering

• Tapetoretinal degeneration

• Vitamin A deficiency

• Retinoschisis

• Compressive optic neuropathy (see Chap. 8)

• Loss of nasal nerve fibers in glaucoma or optic disc drusen (see Chap. 8)

• Bilateral retrogeniculate damage to the posterior visual pathways (see Chaps. 3 and 12)

Additional testing, when indicated:

• Family history

• Fundoscopy

• Electrophysiology

• Tests of functional disorders, exaggeration and/or malingering (see Chap. 15)

• When indicated: MRI, CT, lab testing

Visual field defects

4.1.2 Ring scotoma

4.1.2 Ring scotoma

Ring Scotoma

Pathogenesis/differential diagnosis

• Tapetoretinal degeneration

• Artifact: lens rim, lens holder. Check the centering of the perimeter lens

• Be sure to use an age-matched addition when examining the central visual field, i.e., within 30° of the center

• A contact lens may be used if artifacts should persist

4.1.3 Artifacts

4.1.3 Artifacts

Eccentric Lens

• Obscuration by: (upper) lid, lashes, orbital margin, prominent brow, nose, lens rim, lens holder, eccentric lens

(These problems can be minimized by giving attention to the alignment of the lens and eye, and giving the patient sufficient rest)

4.1.4 Loss of the monocular temporal crescent

4.1.4 Loss of the monocular temporal crescent

Temporal Crescent

• Contralateral retrogeniculate lesion damaging

- Meyer's loop in the anterior temporal lobe, or

- the rostral limits of primary visual cortex (in the right hemisphere in this instance),

• Nasal retinoschisis (of the left eye in this example)

Visual field defects

Pathogenesis/differential diagnosis

4.2 A general reduction of differential luminance sensitivity (DLS)

• Incorrect refraction; avoid using tinted eye glasses; no bi-, tri-, or multifocal lenses; use small rim lenses that are as thin as possible (transposing from plus to minus cylinder can help); correct for presbyopia (see ■ Table 4.3)

• Media opacities

• Diffuse loss of ganglion cells/partial optic atrophy common, e.g., in early open angle glaucoma and "recovered" optic neuritis

Central Scotoma

4.3 Central scotoma

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  • jaana
    What is a monocular temporal crescent?
    3 years ago
  • paride giordano
    What is a optic nerve temporal cresecent?
    1 year ago
  • Ria
    What is temporal crest optic nerve?
    3 months ago

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