Oculographic diagnosis of hemineglect in patients with homonymous hemianopia

Two patients with complete dense left homonymous hemianopia of acute onset are presented. There was a striking difference in visuospatial orientation between them in the early stages of their disease, due to additional left hemineglect in the second patient. While eye movement patterns known to be typical for homonymous hemianopia were found in the first patient by means of infrared reflection oculography, the second showed several findings which could be attributed to hemineglect. Based on these observations and those described in earlier literature, oculographic criteria are listed that enable hemineglect to be detected in the presence of homonymous hemianopia. The practical importance of diagnosing hemineglect with objective and quantitative methods is stressed.