1) The document presents 25 cases of patients with various neurological visual field defects seen at the Baroda Ophthalmic Society between 2003-2013. The cases describe the patient's history, examination findings, visual fields, imaging results and progression over time. 2) Case examples include patients with gradual or sudden vision loss, optic atrophy, optic neuropathy, occipital lobe tumors, pituitary adenomas and other conditions affecting the visual pathway. Serial visual fields are presented to track the progression of defects for several patients over multiple years. 3) Different types of visual field defects are documented, including centro-caecal defects, hemianopic defects, and those combining glaucoma and neurological components. The cases

1. Neurological fields
Baroda Ophthalmic Society
March 2013

2. Case 1.

3. Case 1. Gradual Loss
M/55, 2003
DV 2 months, difficulty in reading
Stroke 4months, Squint

4. Case 1. M/55, 2003
V 6/9
Pupil brisk
V 6/9
IOP 13
Pupil brisk
IOP 14

6. Case 1: follow up 2009

7. Case 1. comparison 2003-2009

9. 20-5-06 RE Case 2. 20-5-06 LE

10. Case 2. Sudden Loss
M/38
ROAD ACCIDENT

11. Case 2.
Trauma 4/5/2006, UNCONCIOUS DV LE NOTICED LATER
6/9 6/36, nasally
Pupil brisk Pupil sluggish
IOP 11 IOP 14

12. 2007 2008

13. Case 2 follow up
• 19-11-2008: RE 6/9, LE 6/12
• LE PUPIL SLUGGISH
• 28-1-2010: LE 6/12, NEAR +1.5=N10

14. Case 3. Fields 27-11-09

15. Case 3.
M/50
22-8-2007
Dimness LE 6/24,
NS grade III
Hypertensive

16. Case 3
• IOP RE 17, LE 13
• Pupils reacting normally
• LE Phaco 14-9-07
• Post op 6/9 till 19-6-08

17. Case 3
• Head Injury on 16-8-09, left temporal region
• Reports loss of vision on 26-11-09.
• MRI for left optic canal, nerve, reported NAD
• Vision LE FC 2’
• IOP 16 OU

18. Case 3 Fundus 2-12-09

19. Case 3 LE
Naked Vessls
RNFL

20. Case 3. Sequence

21. Case 3 on 7-5-12
• RE 6/9
• LE upper half 6/12
• IOP 13 OU on Brimolol

22. RE Case 4: Fields 2009 LE

23. CASE 4 Gradual Loss
M/69
2009
DV FOR NEAR 3 MONTHS

24. Vision:
RE 6/18 (-1.0 -1.0 90*)
LE 6/18 (-1.0 -1.0 90*)
Cataract NS III
IOP 26 OU

25. CASE 4:
Severe episcleral venous congestion
CT SCAN NORMAL

26. Case 4: Disc Cupping

27. Case 4: Disc Cupping
• RNFL LOSS

29. Case 4:
• RE Phaco + Trab on • LE phaco + Trab on
• 8-3-2011 • 4-2-2010
• IOP 12 with topical • IOP 13 with topical
drops drops

30. Case 4: Follow up
RE 6/9

31. IOP
RE 12
LE 13

32. Glaucoma +
?Cavernous
sinus

34. Case 5

35. CASE 5

36. Case 5
• F/65, 19-5-12, dimness 1 year
• Hypermetrope, OU +1.5=6/9,
• Advanced cupping L>R
• IOP 15, 13 without treatment
• Pupils RE brisk LE Sluggish

37. Optic Disc

38. Fields 25-5-12
IOP
RE 16
LE 14
TRAVACOM
MRI
FEW CH ISCHEMIC FOCCI
BILAT. FRONTO-PARIETAL
PARIETO-OCCIPT

39. Fields 12-12-12
IOP
RE 13
LE 15
TRAVACOM
ADD BRIMO

40. Fields 22-3-13
IOP
RE 15
LE 15
CCT
RE 539
LE 544

41. Fields comparision

42. Case 5: SIGNIFICANT CUPPING IN
HYPERMETROPE

43. Case 6: Sudden Loss
20-10-04
M/43
Vision RE 6/9
LE FC 6’

44. Case 6
2005

45. Perimetry done elsewhere in July 2004
Medmont cluster analysis

46. Case 6 20-10-04

47. Case 6: LE Field 20-10-04

48. Case 6: came again on 24-2-2005
• Vision RE 6/12, LE 6/36
• Pulpil RE Brisk, LE Ill Sustained

49. Multiplesclerosis

50. Case 6:
Last followup 4-3-2005

51. Case 7 (2003)

52. Case 7: Gradual loss
24-6-1999
F/42

53. Case 7: History
• Dimness RE 8 months
• Diagnosed Optic Atrophy elsewhere
• NIDDM
• Vision RE FC 4’, LE -2.5 90*= 6/18
• Pupil RE Sluggish, LE Brisk

54. Case 7: Fundus Pictures

55. • Treated with Inj Methyl Pred IV.

56. Case 6: 22-07-2003

63. Types of Neurological defects
CENTRO-CAECAL
HEMI- QUADRANT ANOPIA
GLAUCOMA + NEUROLOGICAL FIELD LOSS

64. 25 cases with documented
neurological fields

67. •Case 3

68. Case 3: F/50 MAY 1993
DV GRADUAL 1WEEK HEADACHE VOMITING 2DAYS

70. Case 3: Follow up 2005

71. CASE 3: Follow up 2012

73. • MACULAR DEGENERATION
• GLAUCOMA
• MACULAR HOLES
• RETINITIS PIGMENTOSA
• HEMIANOPIA
• CHORIORETINITIS
• CONE DYSTROPHES
• BEST'S DISEASE
• STARGADT'S DISEASE
• ACHROMATOPSIA
• LEBER'S OPTIC ATROPHY
• Ischemic optic neuropathy
• Optic neuritis
• Occipital lobe tumours
• Pituitary adenoma
• Other Causes: V