[Differential diagnosis of visual field defects : From the findings to the diagnosis]

In many cases evaluating visual field findings enables precise topodiagnostics and can often directly lead to a concrete suspected diagnosis. In the routine clinical practice, the most useful examination strategy is 30° automatic grid perimetry; however, a visual field examination is not objective and depends heavily on the patient's cooperation. Therefore, the quality of the investigation, the plausibility and usability of every perimetry finding should be assessed. To categorize visual field defects topodiagnostically, it is important to determine whether the defects are monocular or binocular. Defects respecting the horizontal midline indicate nerve fiber bundle defects with a site of damage in the area of the optic nerve head, while defects respecting the vertical midline indicate visual pathway damage directly prechiasmal up to the visual cortex.