Retinal Hemifield Slide Phenomenon

Summary: Retinal Hemifield Slide Phenomenon • Problem: Two visual fields slide because the hemifields do not align, causing diplopia • Patient: Non-overlapping visual field defects with remaining field juxtaposition 1. Bitemporal hemianopsia (2/2 pituitary adenoma, for example) 2. Super-altitudinal OD, Inferior-altitudinal OS or vice-versa • Mechanism: 1. Typically, there is overlap between your OD temporal field and OS nasal field (and vice versa) 2. In bitemporal hemianopsia, you have two juxtaposed nasal fields because the temporal fields are knocked out 3. These juxtaposed nasal fields can slide -Vertical slide -hypertropia -Horizontal slide -esotropia or exotropia 4. This sliding breaks the fusional mechanism, causing a non-paretic diplopia (aka no weakness