Residual vision with awareness in the field contralateral to a partial or complete functional hemispherectomy

Two patients with unilateral disconnection or removal of the entire occipital lobe were tested for residual vision in their blind field. Using image stabilization to eliminate eye motion artifacts, the central portion of each subject's visual field was tested, beginning 1 degree from fixation and extending outward to 13.5 degrees. A narrow zone of residual vision was identified along the retinal vertical meridian of each patient. The lateral edge of this zone was generally within 3.5 degrees of the vertical meridian, though extended farther outward (but not beyond 6 degrees) at one field location for each subject. In one patient, it was present in both superior and inferior quadrants; in the other, it was confined to the superior quadrant. Within their zones of residual vision, both patients could detect stimuli and perform simple shape discriminations, but could not name complex line drawings. The patients were aware of their vision within this zone. No residual vision, with or without awareness, was found in areas tested outside these zones. Given the complete absence of visual cortex contralateral to the observed residual vision, alternate structures must be mediating these abilities.