Isolated Traumatic Bitemporal Hemianopia.

Area of Science:

• Ophthalmology
• Neurology
• Trauma Surgery

Background:

• Bitemporal hemianopia is an uncommon visual field defect.
• Severe head injuries, particularly from trauma, can lead to delayed diagnosis of visual disturbances.

Observation:

• A case study of a 20-year-old male with traumatic bitemporal hemianopia after a motorbike accident.
• Initial presentation included severe head injury, intubation, and acute bilateral vision blurring.
• Ophthalmologic assessment revealed reduced visual acuity and confirmed bitemporal hemianopia via visual field testing.

Findings:

• CT scan showed extensive facial bone fractures, including frontal bone, orbital roof, and paranasal sinuses.
• Despite conservative management and improved visual acuity to 6/6, Humphrey visual field testing confirmed persistent bitemporal hemianopia.
• A discrepancy exists between good visual acuity and significant visual field defects.

Implications:

• Highlights the importance of surveillance for bitemporal scotoma in head injury patients.
• Suggests that midline facial bone fractures warrant thorough ophthalmologic evaluation.
• Emphasizes the need for comprehensive visual field assessment in traumatic brain injury cases.