Wernicke's hemianopic pupil is seen in the lesion of
Wernickes hemianopic pupil is seen in the lesion of optic tracts - characterized by contralateral homonymous hemanopia with a characteristic pupillary response. Narrow beam of light when shown into the non-seeing pa of the retina, pupil fails to react while when shown into the seeing pa of the retina, pupillary constriction occurs. Make your concept - Homonymous means same side (i.e. right or left) - Heteronymous means opposite side (i.e. nasal or temporal) - Congruous means same shape or symmetric on both sides - Incongruous means different shape or asymmetric on both sides - Hemianopia means half side is involved - Generally Anterior lesions cause heteronymous, incongruous defects and posterior lesions cause more homonymous and congruous defects Impoant Points on Visual Pathway Lesions 1. Optic nerve lesion - I/l direct and c/ L consensual gone Causes - optic atrophy/ optic neuritis - avulsion optic nerve 2. Proximal pa of optic nerve - I/L blindness C/L hemianopia 1. Saggital chiasma lesion - Bitemporal hemianopia - Paial descending optic atrophy Causes - suprasellar aneurysm - tumors of pitutory craniopharyngioma - suprasellar meningioma 2. Lateral chiasma - Binasal hemianopia of pupillary reflex Causes - Distention of 3rd ventricle Since some fibres of other side there is crossover Binasal Hemianopia 3. Optic tract Lesion- - Contralateral homonymous hemianopia with incongruity - Bow tie pattern of optic atropy 5.Temporal lobe lesion - contralateral homonymous superior quadrantanopia (pie in the sky defect) 6. Parietal Lobe lesion- Pie in the floor. Contralateral homonymous inferior quadrantanopia Homonymous hemianopsia, also referred to as homonymous hemianopia is the loss of half of the field of view on the same side in both eyes. Left superior homonymous quadrantanopia Left inferior homonymous quadrantanopia 7.Keyhole visual field defects: Vascular lesion of Lateral Geniculate body 8. Occipital lobe lesion Congruous homonymous hemianopia with sparing of macula Cause: Occlusion of posterior cerebral aery Congruous Homonymous macular defect Cause: Bullet injury/ head injury Bilateral homonymous macular defect Cause: Bilateral occipital defect
Optic tract
Optic nerve
Optic chiasma
Occipital lobe (visual coex)
Neuro Ophthalmology