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April 1985

Importance of Evaluating the Central Visual Field in Occipital Lobe Lesions

Arch Neurol. 1985;42(4):309-310. doi:10.1001/archneur.1985.04060040015003

To the Editor.  —The article by Drs Castro-Caldas and Salgado entitled "Right Hemifield Alexia Without Hemianopia"1 raises an important issue in visual field testing with occipital lobe lesions. They reported that the visual field in their patient was normal. However, they only documented testing of the peripheral visual fields, that is, the visual field outside 30° (Figure, a). A review of our last ten patients with visual field defects due to occipital lesions from ischemic cerebrovascular disease revealed that three of these patients had defects that would have been missed had the central 30° not been tested (Figure, b to d).It is well known that retrochiasmatic visual field defects rarely involve the peripheral field without involving the central field, but it is not uncommon for them to involve the central field and spare the peripheral field.2-4 In a series of 262 patients with lesions of the visual pathways