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March 1, 1976

Homonymous Hemianopsia? Does Confrontation Get You Down?

Author Affiliations

Tucson, Ariz

JAMA. 1976;235(9):908-909. doi:10.1001/jama.1976.03260350014011

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To the Editor.—  In the gross evaluation of visual fields done as part of the neurological examination, you have been taught to face the patient, each of you with one eye covered, to compare his peripheral vision with your own. You ask him to tell you when he can see your finger zeroing in from the side, but this makes him dart a glance in its direction so that you are never sure what part of the field he is using, peripheral or foveal.Now comes a new wrinkle in this old test in which the doctor confronts the patient in the same manner, but holding the index finger of each hand out to each side at 180 degrees. By asking the patient to tell which finger is wiggling, you can accurately tell a defect in the peripheral fields. The patient's gaze is fixed in the center, on your own