__ VISUAL PATHWAY: + High- -Yield Anatomy & Lesions < Pa PATHWAY OF [THE VISUAL FIELD: | Pa INFORMATION: Area the eye can see. @ RETINA LEFT VISUAL FIELD RIGHT VISUAL FIELD v (LEFT sive) (RIGHT SIDE) @ (_ optic Nerve @® ( optic cHIASM ® Sy! \ LEFT 56 > \ , i ax oS | Left Feld | ' @ @ | L Riatt sive > | | Right field | @ THE INVERSE RULE: Occipital Lo © Nasal retina sees Temporal field, x (WHY 1S IT IMPORTANT?) of - Te | retina ee Nasal field _ ® Lesions at different points © Superior retina sees Inferior field, produce, different defects. Tnferior retina sees Superior field. © Predict the lesion by. understanding the pathway. Nasal —> Temporal, Temporal —> Nasal. —_—_— — Optic nerve ust & — Optic chiasm EYE PRMARY — Optic tract |— VISUAL — Optic radiation CoRTeX 23 © Lan Ricur & (Occipital Lo — Primary visual cortex EYERETINAL FIBERS: ue types. @ TEMPORAL FIBERS: LEFT EYE RIGHT EYE + Remain UNCROSSED, Continue on same side, pass through chiasm without crossing. OPTIC CHIASM @ NASAL FIBERS: * CROSS at the optic chiasm. * Crossing is called DECUSSATION. LEFT RIGHT = 5 OPTIC ~s, <— OPTIC TRACT TRACT Nasal > CROSS Temporal —> Do NOT CROSS — TEMPORAL FIBERS (UNCROSSED) —— NASAL FIBERS (CROSS) * OPTIC CHIASM:: Point where Nasal fibers cross to opposite side and Temporal fibers stay ipsilateral. * Example: LEFT OPTIC TRACT contains Left Temporal Fibers + Right Nasal Fibers % GOLDEN RUL E: Each optic tract carries information from the CONTRALATERAL visual field.7X = FROM RETINA To CORTEX: (4) OPTIC NERVE: Lert eve Riga EYE na ea x Carries info from one eye. @orne cuiasm, ff ( Nasal fibers cross. (3) OPTIC TRACT: Contains Ipsilateral temporal + Contralateral nasal fibers. (* 4) LGN (Larerat GENICULATE Nucteus):¢ Relay station in Thalamus. (5) optic RApiAtion Fibers spread toward visual cortex through Parietal and Temporal lobes. © PRIMARY VISUAL CORTEX: Occipital Lobe.> OPTIC RADIATION: < From LGN, two major routes. PARIETAL @ SUPERIOR / PARIETAL PATHWAY: ¢ Parietal lobe, carries info about INFERIOR VISUAL FIELD. @ INFERIOR / TEMPORAL PATHWAY (MEYER’S LOOP): [ \ * Temporal lobe, carries info about SUPERIOR VISUAL FIELD. MEYER'S LOOP Superior fibers —> Inferior field Inferior fibers —> Superior fieldVISUAL PATHWAY LESIONS: The location determines the defect. LESION VISUAL DEFECT Monocular blindness. ¥ Optic chiasm a , DHE ) nace Lateral Binasal optic chiasm : | hemianopia. Contralateral homonymous hemianopia. . >, Contralateral ty Parietal » inferior radiation ) ! quadrantanopia. tr Temporal ~ Contralateral radiation Z Se quadrantanopia. o» Contralateral cortex ) } visual-field loss.OPTIC NERVE LESION: + Affects info from ONE EYE. * Result: MONOCULAR BLINDNESS. Complete loss of vision in affected eye. OPTIC CHIASM LESION: ee hla <= FIBERS = \ (cross) JZ * Central lesion damages NASAL RETINAL FIBERS (Fibers that CROSS). © Result: ey } \ if CHIASM BITEMPORAL HEMIANOPIA. ij . a * Classic association: wy ON PITUITARY ADENOMA (lies close to chiasm). f ADENOMA COMPRESSES OPTIC CHIASM. (4 gy EXAM PEARL: Optic chiasm __,, Bitemporal compression hemianopia. Pituitary tumor —>“LATERAL CHIASM LESION: Damages TEMPORAL RETINAL FIBERS (do not cross). —> Result: BINASAL HEMIANOPIA. BINASAL_HEMIANOPIA LEFT EYE VIEW NASAL FIELD TEMPORAL RIGHT EYE VIEW FIBERS) NASAL FIELD "west * Central chiasm (Nasal) > Bitemporal. * Lateral chiasm (Temporal) -> Binasal. “OPTIC TRACT LESION: CONTRALATERAL * Carries info from CONTRALATERAL VISUAL FIELD. HOMONYMOUS QO Example : LEFT OPTIC TRACT (Left temporal + Right nasal) HEMIANOPIA —> RIGHT VISUAL FIELD. LEFT OPTIC TRACT LESION —> Result: CONTRALATERAL HOMONYMOUS HEMIANOPIA. | > RIGHT VISUAL FIELD Loss VIEW FROM ABOVE Lert RIGHT VISUAL FIELD VISUAL FIELD ® a RIGHT = visuat. FIELD Lost & KEY RULE: Optic tract lesion —> Contralateral homonymous hemianopia. pata Y' P/ 7 =- s = OPTIC RADIATION LESIONS 4 PARIETAL (SUPERIOR) (@) PARIETAL / SUPERIOR: ¢ Carries INFERIOR field. Lesion > CONTRALATERAL INFERIOR QUADRANTANOPIA. Carries Carries SUPERIOR (2) TEMPORAL / INFERIOR (weve Loo): ¢ Carries SUPERIOR field. TEMPORAL Field : * (inerion) \" Lesion > CONTRALATERAL eet SUPERIOR QUADRANTANOPIA. He MEYER’S LOOP: Temporal lobe. | Je MEMORY TRICK: “Pie in the Sky” ‘ (Superior loss). r EXAMPLE: INFERIOR QUADRANTANOPIA (eg., Parietal / Superior lesion) PARIETAL OPTIC RADIATION: Superior pathway. LEFT VISUAL FIELD RIGHT VISUAL FIELD (seen by leFt eye) (Seen by right eye) q - fs LOSS of INFERIOR QUADRANTS MEMORY: in BOTH eyes v Parietal > Below CONTRALATERAL INFERIOR t QUADRANTANOPIA jemporal > AbovePRIMARY VISUAL CORTEX : Occipital Lobe. Final destination of major visual pathway. Damage produces CONTRALATERAL VISUAL FIELD LOSS. % Cortex processes info from the OPPOSITE VISUAL FIELD. VisuAL PATHWAY — MASTER MAP: @® RetINA 4 ® Otic Nerve (Lesion: Monocular blindness) 4 © Opric CHiAsM Nasal fibers CROSS (Lesion: Bitemporal hemianopia) + ® Oerie Tract Contralateral field (Lesion: Contralateral homonymous hemianopia) © LGN (Thalamic relay) pagierar a 4 (Inferior Field) © Otic RADIATION © PARIETAL: Inferior field/ quadrantanopia * TEMPORAL/MEYER’S: Superior: field (quadeantaropia MEYER'S (Superior Feld) @ Primary VisuaL Cortex (Occipital lobe) TEMPORAL / eX VISUAL FIELDS Leet VISUAL FIELD RIGHT VISUAL FIELD Lesion: Monocular blindness Lesion: Bitemporal hemianopia Lesion: Contralateral homonymous hemianopia ‘Inferior field) _— TEMPORAL / MEvER'S (Superior Field) OCCIPITAL LOBE¢*, EXAM RAPID REVIEW: , * Se oe YOU SEE THIS > THINK THIS. Optic nerve =—> Monocular blindness. @ ee oe Central optic chiasm —> Bitemporal hemianopia. < Lateral optic chiasm —> Binasal hemianopia. Optic tract Contralateral Ae Optic tract > err Oo © Cy Parietal radiation —> cn Te ( radiati ee Contralateral CO ies am © Visual cortex —> Geen D D > te THE 5 RULES To NEVER FORGET: yx < @ Nasal fibers CROSS. p< ) Temporal fibers DON'T CROSS. = @) Optic tract = CONTRALATERAL visual Feld. O- -O @) Meyer’s loop = SUPERIOR visul fell. Z\> @& ©) Parietal radiation = INFERIOR visul Feld. ~\ > @ “Jy FINAL CONCEPT: @ Don’t memorize the lesion. Follow the fibers > 4 predict the visual field defect.