Isolated complete bitemporal hemianopia in traumatic chiasmal syndrome

Area of Science:

• Neuro-ophthalmology
• Trauma Surgery

Background:

• Traumatic chiasmal syndrome can result from head injuries, potentially affecting vision.
• Bitemporal hemianopia, a specific visual field defect, is a known but uncommon consequence.

Observation:

• A 29-year-old man experienced lateral blindness in his left eye four months post-fall.
• Visual field testing revealed a complete bitemporal hemianopic defect.
• Orbital CT showed frontal skull and sphenoid bone fractures with frontal lobe injury, but no direct visual pathway abnormalities.

Findings:

• Optical coherence tomography indicated reduced retinal nerve fiber layer thickness in the left eye.
• The patient presented with a complete bitemporal hemianopia despite the absence of neurological deficits.

Implications:

• This case represents an extremely rare presentation of traumatic chiasmal syndrome.
• It underscores the complex and sometimes atypical visual pathway damage following head trauma.
• Further research into the mechanisms of visual field defects in traumatic brain injury is warranted.