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Bitemporal hemianopia caused by bilateral blepharoptosis.

Benjamin M Levine1, Gary J Lelli

  • 1Weill Cornell Medical Center, Ophthalmology, New York, NY, USA.

Orbit (Amsterdam, Netherlands)
|December 17, 2010
PubMed
Summary
This summary is machine-generated.

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Bitemporal hemianopia, a visual field defect, can rarely be caused by eyelid ptosis. Raising the eyelids resolved the defect, highlighting the importance of considering eyelid position in visual field testing.

Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology

Background:

  • Peripheral visual field loss is a common visual complaint.
  • Bitemporal hemianopia, affecting both temporal visual fields, suggests optic chiasm pathology.

Observation:

  • A 49-year-old woman presented with peripheral visual field loss.
  • Humphrey Visual Field (HVF) testing revealed a bitemporal hemianopia.
  • Magnetic resonance imaging (MRI) of the optic chiasm showed no abnormalities.

Findings:

  • The bitemporal hemianopic defect resolved upon repeat HVF testing after manually elevating the patient's upper eyelids.
  • This suggests the visual field defect was artifactual, caused by eyelid ptosis.

Implications:

  • Eyelid ptosis, particularly with lateral hooding, can mimic serious neurological or ophthalmological conditions.

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  • Clinicians should consider eyelid position as a potential cause of apparent visual field defects.
  • This case underscores the importance of a thorough physical examination in interpreting visual field test results.