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Review these patterns in Table 5-4, Visual Field Defects, p. 176.

glass bowl that encircles the front of the patient's head. Ask the patient to look with both eyes into your eyes. While you return the patient's gaze, place your hands about 2 feet apart, lateral to the patient's ears. Instruct the patient to point to your fingers as soon as they are seen. Then slowly move the wiggling fingers of both your hands along the imaginary bowl and toward the line of gaze until the patient identifies them. Repeat this pattern in the upper and lower temporal quadrants.

Normally, a person sees both sets of fingers at the same time. If so, fields are usually normal.

Further Testing. If you find a defect, try to establish its boundaries. Test one eye at a time. If you suspect a temporal defect in the left visual field, for example, ask the patient to cover the right eye and, with the left one, to look into your eye directly opposite. Then slowly move your wiggling fingers from the defective area toward the better vision, noting where the patient first responds. Repeat this at several levels to define the border.

When the patient's left eye repeatedly does not see your fingers until they have crossed the line of gaze, a left temporal hemianopsia is present. It is diagrammed from the patient's viewpoint.

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