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Visual Field Defects - Left Hemianopia with Macular Sparing

Defective Visual Field with Left Half-nope-eyes and Macula-Dracula
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Left hemianopia with macular sparing is a partial loss of vision in the same half of both eyes with the center, the macula, spared. A lesion of both the dorsal radiation and Meyer’s loop in the occipital lobe causes this blindness. The lesion can be due to a posterior cerebral artery infarct causes ischemia of the visual cortex. Dual supply to the region associated with macular sight, supplied by the PCA and middle cerebral artery, explains the sparing of the macula.
5 KEY FACTS
VISUAL FIELD ABNORMALITY
Left Hemianopia with Macular Sparing
Left Half-nope-eyes with Macula-Dracula

This is a partial loss of vision in both eyes in which the center vision is normal or spared.

Vision Loss - Same Side in Both Eyes
Left Side Darkened in Both Eyes

Almost half of the visual field is lost, and it is the same half in both eyes. 

Center Spared
Center of Macula-Dracula Spared with a Spare-tire

A small circular area in the center of the eye, the macula, is spared from vision loss due to its bitemporal projection to the occiput.

LOCATION OF LESION
Occipital Lobe
Octopus

Both the dorsal optic radiation and Meyer’s loop are lesioned in the occipital lobe. The occipital lobe is the most posterior portion of the head and are considered the visual processing center of the brain.

CAUSES
Posterior Cerebral Artery (PCA) Infarct
Post Brain Artery clogged with PCA

There is dual blood supply from the posterior cerebral artery and middle cerebral artery to the area of the visual cortex associated with macular sight.  When there is an infarct of the PCA, the visual cortex becomes ischemic and loses function, except for the region supplying the macula, which remains nourished by the MCA.

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