A clinical case report of left homonymous hemianopia

Abstract

Introduction: Homonymous hemianopia (HH), which refers to defects in the same half of the visual field in each eye, results from lesions that are posterior to the optic chiasm. Homonymous hemianopia may be classified as complete or incomplete depending on the characteristics of the visual field defect.

Patient presentation: A 40-year-old woman was referred to the eye clinic. Her chief complaint was visual field loss, where she was unable to see objects to the left when looking straight ahead. The ocular examination revealed left complete HH without macular sparing.

Management and outcome: The patient was fitted and trained with peripheral prism spectacles for distance viewing according to the method proposed by Peli. In the follow-up examinations, the patient subjectively reported improved awareness of objects on the left and better functional vision with the peripheral prism spectacles. Furthermore, the Humphrey Visual Field Analyser findings showed that the patient had some level of awareness of the test stimuli in the left field when wearing the peripheral prism spectacles.

Conclusion: The presence of HH affects functional vision and quality of life, and may be managed using peripheral prism spectacles to improve awareness of objects on the affected side of the visual field.

Contribution: This case report demonstrates the potential of rehabilitation efforts using peripheral prism spectacles and training, at this university-based low vision eye clinic, to improve functional vision and quality of life in individuals with HH.