ONE of the most dependable axioms in ophthalmology is that bitemporal hemianopsia indicates a lesion at the optic chiasm. The following cases demonstrate that even to this rule there may be exceptions which can occasionally cause difficulty in diagnosis.
REPORT OF CASES
—A man aged 31 complained of thoracic pain on exertion, which was considered by his internist to be due to angina pectoris. In the course of his examinations the patient requested refraction, although he had not had any ocular symptoms. Refraction indicated that the following correction was required: right eye, —0.25 D. sph.[unk]—1.75 D. cyl., axis 140 ; left eye, —0.75 D. sph.[unk]—1.50 D. cyl., axis 170. The visual acuity of 6/12 in each eye afforded by these lenses did not satisfy the refractionist ; consequently, he requested further studies.Ophthalmoscopic examination (fig. 1A) disclosed a downward tilting of the optic disks and
RUCKER CW. BITEMPORAL DEFECTS IN THE VISUAL FIELDS RESULTING FROM DEVELOPMENTAL ANOMALIES OF THE OPTIC DISKS. Arch Ophthalmol. 1946;35(5):546–554. doi:10.1001/archopht.1946.00890200559008
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