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February 1974

Chiasmatic Lesions-Reply

Author Affiliations

Vancouver, British Columbia, Canada

Arch Ophthalmol. 1974;91(2):168. doi:10.1001/archopht.1974.03900060174021

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To the Editor.  —I think that the letter written by Dr. Kaplan raises some very interesting points that should be further amplified.In the first place, all the patients who had temporal field defects had typical glaucomatous changes at the optic nerve head, including involvement of the nasal neuroretinal rim in many cases. In almost all of the patients, even in those with nerve head changes, a full neurovascular assessment, including ophthalmodynamometry and x-ray films of optic foramina and the skull, was carried out.The point raised by Dr. Kaplan should be reemphasized, namely that glaucomatous patients who have a temporal visual defect, even with changes at the optic nerve head, should have the possibility of a spaceoccupying lesion involving the chiasm ruled out.

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