[Rehabilitation of lesions in the visual pathways]. 2009

S Trauzettel-Klosinski
Sehbehindertenambulanz, Universitäts-Augenklinik Tübingen, Schleichstrasse 12-16, Tübingen. susanne.trauzettel-klosinski@uni-tuebingen.de

This review considers diseases of the visual pathways at different levels, their consequences for relevant everyday functions and their rehabilitation. Infrachiasmatic lesions are mostly associated with central or ring scotomas causing reading problems. The use of an eccentric fixation locus in combination with text magnification often allows the patient to maintain reading ability. Chiasmatic lesions can cause orientation disability by bitemporal hemianopia and reading problems by slide phenomena along the vertical midline. Suprachiasmatic lesions lead to homonymous visual field defects. Regarding the hemianopic orientation disorder, there are two different training approaches, which have been discussed controversially: restitution of the visual field by visual stimulation versus compensation by explorative eye movements towards the hemianopic side. Previously described positive effects of exploration training were not entirely convincing due to the lack of control groups. A new randomised and controlled study has proved the effectiveness of exploration training and showed that the patients apply the improved exploration strategy to everyday life. In the control group, which received a visual field stimulation training--a potential restitution training--neither exploration nor visual fields changed. The hemianopic reading disorder depends on the distance of the field defect from the centre, i. e., the size of the reading visual field, the side of the field defect in regard to the reading direction and the presence of spontaneous adaptive strategies, such as eccentric fixation or predictive saccades. Specific reading training can be helpful. Cerebral visual impairments with visual field defects are often associated with disorders of information processing in higher cortical areas. These complex disorders usually require an interdisciplinary rehabilitation. Specific examination methods to assess functions of everyday relevance and their use as a basis for rehabilitation measures are discussed. Visual rehabilitation can be very successful in many cases and improves the patients' quality of life. One should expect that the demand for neuro-ophthalmological rehabilitation will increase, because the survival rate after severe cerebral lesions and the general lifespan are rising.

UI MeSH Term Description Entries
D009897 Optic Chiasm The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. Chiasma Opticum,Optic Chiasma,Optic Decussation,Chiasm, Optic,Chiasma Opticums,Chiasma, Optic,Chiasmas, Optic,Chiasms, Optic,Decussation, Optic,Decussations, Optic,Optic Chiasmas,Optic Chiasms,Optic Decussations,Opticum, Chiasma,Opticums, Chiasma
D010468 Perceptual Disorders Cognitive disorders characterized by an impaired ability to perceive the nature of objects or concepts through use of the sense organs. These include spatial neglect syndromes, where an individual does not attend to visual, auditory, or sensory stimuli presented from one side of the body. Hemispatial Neglect,Hemisensory Neglect,Sensory Neglect,Somatosensory Discrimination Disorder,Discrimination Disorder, Somatosensory,Discrimination Disorders, Somatosensory,Hemisensory Neglects,Hemispatial Neglects,Neglect, Hemisensory,Neglect, Hemispatial,Neglect, Sensory,Neglects, Hemisensory,Perceptual Disorder,Sensory Neglects,Somatosensory Discrimination Disorders
D011932 Reading Acquiring information from text.
D004185 Disability Evaluation Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits. Disability Evaluations,Evaluation, Disability,Evaluations, Disability
D006423 Hemianopsia Partial or complete loss of vision in one half of the visual field(s) of one or both eyes. Subtypes include altitudinal hemianopsia, characterized by a visual defect above or below the horizontal meridian of the visual field. Homonymous hemianopsia refers to a visual defect that affects both eyes equally, and occurs either to the left or right of the midline of the visual field. Binasal hemianopsia consists of loss of vision in the nasal hemifields of both eyes. Bitemporal hemianopsia is the bilateral loss of vision in the temporal fields. Quadrantanopsia refers to loss of vision in one quarter of the visual field in one or both eyes. Hemianopsia, Binasal,Hemianopsia, Bitemporal,Hemianopsia, Homonymous,Quadrantanopsia,Altidudinal Hemianopia,Altitudinal Hemianopsia,Binasal Hemianopia,Bitemporal Hemianopia,Hemianopia,Homonymous Hemianopia,Quadrantanopia,Altidudinal Hemianopias,Altitudinal Hemianopsias,Binasal Hemianopias,Binasal Hemianopsia,Binasal Hemianopsias,Bitemporal Hemianopias,Bitemporal Hemianopsia,Bitemporal Hemianopsias,Hemianopia, Altidudinal,Hemianopia, Binasal,Hemianopia, Bitemporal,Hemianopia, Homonymous,Hemianopias,Hemianopias, Altidudinal,Hemianopias, Binasal,Hemianopias, Bitemporal,Hemianopias, Homonymous,Hemianopsia, Altitudinal,Hemianopsias,Hemianopsias, Altitudinal,Hemianopsias, Binasal,Hemianopsias, Bitemporal,Hemianopsias, Homonymous,Homonymous Hemianopias,Homonymous Hemianopsia,Homonymous Hemianopsias,Quadrantanopias,Quadrantanopsias
D001296 Audiovisual Aids Auditory and visual instructional materials. Visual Aids,Audio-Visual Aids,Aid, Audio-Visual,Aid, Audiovisual,Aid, Visual,Aids, Audio-Visual,Aids, Audiovisual,Aids, Visual,Audio Visual Aids,Audio-Visual Aid,Audiovisual Aid,Visual Aid
D012607 Scotoma A localized defect in the visual field bordered by an area of normal vision. This occurs with a variety of EYE DISEASES (e.g., RETINAL DISEASES and GLAUCOMA); OPTIC NERVE DISEASES, and other conditions. Scotoma, Arcuate,Scotoma, Bjerrum,Scotoma, Central,Scotoma, Centrocecal,Scotoma, Altitudinal,Scotoma, Paracecal,Scotoma, Paracentral,Scotoma, Peripheral,Scotoma, Ring,Scotoma, Scintillating,Scotoma, Sector,Altitudinal Scotoma,Altitudinal Scotomas,Arcuate Scotoma,Arcuate Scotomas,Bjerrum Scotoma,Bjerrum Scotomas,Central Scotoma,Central Scotomas,Centrocecal Scotoma,Centrocecal Scotomas,Paracecal Scotoma,Paracecal Scotomas,Paracentral Scotoma,Paracentral Scotomas,Peripheral Scotoma,Peripheral Scotomas,Ring Scotoma,Ring Scotomas,Scintillating Scotoma,Scintillating Scotomas,Scotomas,Scotomas, Altitudinal,Scotomas, Arcuate,Scotomas, Bjerrum,Scotomas, Central,Scotomas, Centrocecal,Scotomas, Paracecal,Scotomas, Paracentral,Scotomas, Peripheral,Scotomas, Ring,Scotomas, Scintillating,Scotomas, Sector,Sector Scotoma,Sector Scotomas
D014793 Visual Cortex Area of the OCCIPITAL LOBE concerned with the processing of visual information relayed via VISUAL PATHWAYS. Area V2,Area V3,Area V4,Area V5,Associative Visual Cortex,Brodmann Area 18,Brodmann Area 19,Brodmann's Area 18,Brodmann's Area 19,Cortical Area V2,Cortical Area V3,Cortical Area V4,Cortical Area V5,Secondary Visual Cortex,Visual Cortex Secondary,Visual Cortex V2,Visual Cortex V3,Visual Cortex V3, V4, V5,Visual Cortex V4,Visual Cortex V5,Visual Cortex, Associative,Visual Motion Area,Extrastriate Cortex,Area 18, Brodmann,Area 18, Brodmann's,Area 19, Brodmann,Area 19, Brodmann's,Area V2, Cortical,Area V3, Cortical,Area V4, Cortical,Area V5, Cortical,Area, Visual Motion,Associative Visual Cortices,Brodmanns Area 18,Brodmanns Area 19,Cortex Secondary, Visual,Cortex V2, Visual,Cortex V3, Visual,Cortex, Associative Visual,Cortex, Extrastriate,Cortex, Secondary Visual,Cortex, Visual,Cortical Area V3s,Extrastriate Cortices,Secondary Visual Cortices,V3, Cortical Area,V3, Visual Cortex,V4, Area,V4, Cortical Area,V5, Area,V5, Cortical Area,V5, Visual Cortex,Visual Cortex Secondaries,Visual Cortex, Secondary,Visual Motion Areas
D014794 Visual Fields The total area or space visible in a person's peripheral vision with the eye looking straightforward. Field, Visual,Fields, Visual,Visual Field
D014795 Visual Pathways Set of cell bodies and nerve fibers conducting impulses from the eyes to the cerebral cortex. It includes the RETINA; OPTIC NERVE; optic tract; and geniculocalcarine tract. Pathway, Visual,Pathways, Visual,Visual Pathway

Related Publications

S Trauzettel-Klosinski
January 1957, A.M.A. archives of ophthalmology,
S Trauzettel-Klosinski
January 1996, Therapeutische Umschau. Revue therapeutique,
S Trauzettel-Klosinski
November 2009, Klinische Monatsblatter fur Augenheilkunde,
S Trauzettel-Klosinski
September 1965, Neurology,
S Trauzettel-Klosinski
July 1981, Klinische Monatsblatter fur Augenheilkunde,
S Trauzettel-Klosinski
January 1982, Annals of the New York Academy of Sciences,
S Trauzettel-Klosinski
August 1987, Brain : a journal of neurology,
S Trauzettel-Klosinski
January 1981, Transactions of the Ophthalmological Society of New Zealand,
Copied contents to your clipboard!