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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Reversible Homonymous Inferior Quadrantanopia in a Nonketotic Hyperglycemic Patient.

A López-Amorós1, V Medrano-Martínez1, I Francés-Pont1

  • 1Department of Neurology, Hospital General Universitario Virgen de la Salud, Elda, Spain.

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|February 21, 2020
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Summary
This summary is machine-generated.

Nonketotic hyperglycemia (NKH) can cause sudden, temporary homonymous hemianopia, a type of vision loss. This condition should be considered in diabetic patients with normal neuroimaging results and transient visual field defects.

Keywords:
Homonymous hemianopiaTodd’s phenomenonnonketotic hyperglycemiaquadrantanopiavisual field defects

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Area of Science:

  • Neurology
  • Ophthalmology
  • Endocrinology

Background:

  • Homonymous hemianopia typically results from retrochiasmal lesions, often vascular.
  • Magnetic resonance imaging (MRI) usually identifies vascular causes of vision loss.

Observation:

  • A 62-year-old diabetic female presented with headache, altered color vision, and sudden homonymous inferior quadrantanopia.
  • Blood glucose levels were elevated, but pH was normal, indicating nonketotic hyperglycemia (NKH).
  • Neuroimaging studies were unremarkable.

Findings:

  • The patient's visual field defect resolved following correction of hyperglycemia.
  • This case highlights a non-vascular, metabolic cause of homonymous hemianopia.

Implications:

  • Nonketotic hyperglycemia (NKH) is a crucial differential diagnosis for patients presenting with sudden, transient homonymous hemianopia and normal neuroimaging.
  • Prompt recognition and management of hyperglycemia can lead to rapid visual recovery.
  • This underscores the importance of considering metabolic disturbances in neurological presentations.