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November 1981

Hysterical Bitemporal Hemianopia

Author Affiliations


Arch Ophthalmol. 1981;99(11):2053. doi:10.1001/archopht.1981.03930020931022

To the Editor.  —The article in the Archives by James R. Keane, MD, entitled "Hysterical Hemianopia: The 'Missing Half' Field Defect" (1979;97:865-866) prompts us to describe a patient with hysterical bitemporal hemianopia.

Report of a Case.  —A medically unsophisticated 15-year-old girl was being examined for headaches and blackouts when incomplete bitemporal field loss was discovered. Each time the field was assessed, the bitemporal defects became more apparent and of greater density and began to spread to the inferonasal quadrants; visual acuity remained at 20/25 OU. On each occasion, the defect was strictly aligned along the vertical meridian. Optic atrophy was never seen.Findings from two computed tomographic scans, skull roentgenograms, sella tomography, EEG, cerebral angiography, pneumoencephalography, CSF analysis, and exploratory craniotomy were all normal. Pattern reversal visual evoked response (VER) showed increased latency and decreased amplitude with temporal hemifield stimulation of either eye. Findings from nasal hemifield stimulation were normal.

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