Cases in Emergency Medicine

Optic Chiasm Lesion

Lesions at the optic chiasm cause unusual visual field losses....

The classic field cut of a small compressing lesion at the optic chiasm that impairs the crossing fibers of the visual system but spares the lateral fibers is the bitemporal hemianopsia which has been described as "wearing blinders.".

A larger lesion might destroy the function of the chiasm completely. Pupillary response to light would be absent, since the stimulation of the light does not reach the lateral geniculate bodies.

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