Visual field defects detected in patients with Gilles de la Tourette syndrome: preliminary report

The presence of visual field anomalies was measured using Goldmann kinetic perimetry in twelve patients, age 7 to 39 with Gilles de la Tourette syndrome. Refraction to the cupola was carefully controlled. The visual acuity of the group was good to excellent. Visual field alterations were prechiasmal, generally non-symmetric, and best described as arcuate defects, steps, baring of the blind spot and enlargement of the blind spot. Central fields were most commonly affected, i.e., I/2e to I/1B isopters. There was no evidence of glaucoma in any of the patients although two patients exhibited keratoconus and another one manifested moderate to high astigmatism. Visual involvement other than ocular and lid tics have not been reported in Tourette syndrome. This research represents clear evidence of additional physical components in this condition. Automated visual field measurements are not recommended in this population because of the presence of non-predictable tic and vocal behavior (both may result in head/eye movements). Suppression of tic behavior can be very fatiguing. (Eight of twelve of the patients reported exhibited signs of marked fatigue during testing.)