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KMID : 1038920170160020087
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Annals of Optometry and Contact Lens
2017 Volume.16 No. 2 p.87 ~ p.91
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Bilateral Homonymous Superior Quadrantanopia after Traumatic Brain Contusion
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Shin Hee-Jong
Yun Jun-Myeong
Hwang Hyung-Bin
Yim Hye-Bin
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Abstract
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Purpose: We reported on a rare case of traumatic brain contusion causing bilateral homonymous superior quadrantanopia.
Case Summary: A 55-year-old woman who underwent brain surgery three years ago due to head trauma caused by a traffic accident, visited this clinic on September 2004 because of a 5-month history of worsening visual acuity. Her best corrected visual acuity was 12/20 right, 16/20 left. To figure out if there were any visual field defects or diplopia, a Goldmann visual field test was done. The result of the examination was right superior homonymous quadrantanopia, which could be explained by a left temporal and occipital lobe lesion. On a brain magnetic resonance imaging (MRI), the bilateral temporal lobes and occipital lobes presented encephalomalacic changes, assumed to be sequela of the previous traumatic contusion in 2001. The patient re-visited the clinic in 2013 for decreased visual acuity. We executed a visual field 24-2 Threshold Test to figure out the progression of the visual field defect. The result was bilateral homonymous superior quadrantanopia. On a brain MRI, multifocal encephalomalacic lesions at bilateral temporal and occipital lobes were observed. It was presumed to be an advanced invasion of encephalomalacic change.
Conclusion: Traumatic brain contusions show variable clinical signs and visual field defects. A bilateral homonymous visual field defect is rarely seen. It is important to not forget that contralateral quatrantanopia could occur bilaterally due to brain lesions on both hemispheres and ophthalmologists need to pay more attention when diagnosing patients with atypical visual field defects.
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KEYWORD
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Visual field defect, Homonymous quadrantanopia
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