Congruous homonymous hemianopia due to occipital lobe infarction

K Suresh*, Arpita and Sujitkumar

Optic disorder in which the visual field defects in both eyes are completely symmetric in extent and intensity are defined as Congruous homonymous hemianopia. Here is such a case that I followed early this year. A sixty- five years old male, diabetic since 1994, Hypertensive for 14 years and ischemic heart disease for 10 years under ayurvedic treatment reported with a history of fall from the bed while sleeping in the midnight 11th &12th February 2020 and found himself fully blurred bilateral vision with severe headache on the morning of 15th. After a local consultation and laser therapy attempt did not benefit, he landed in Bangalore. Suspecting diabetic Retinopathy, we took him to Narayana Netralaya a super-specialty eye hospital. Detailed examination by a retina specialist confirmed right homonymous hemianopia with no significant Retinal findings to explain the defective vision. An MRI Brain and Orbit plain and contrast was ordered, that revealed Subacute Ischemic Infarct in Bilateral PCA territory. Other investigations did indicate uncontrolled diabetes hypertension and evidence of Ischemic Heart Diseases S/P PTCA. The case was referred to a neuro-physician who put him on Inj. Perfalgan 1 G IV SOS, Inj. PAN-40 Mg IV once a day x3, Inj. Emeset 4 mg IV SOS, Tab Clopilet A 150 mg once a day in the afternoon and other supportive treatment. There was an improvement in the vision within 24 hours as he could count fingers at 1 foot. Hospital stay lasted for 3 days and the vision was improving day by day. The second follow-up was uneventful but before a bit delayed third follow-up the patient died of cardiac arrest within 2 months of the first episode.

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Published on: Dec 24, 2020 Pages: 105-109

Full Text PDF Full Text HTML DOI: 10.17352/2455-1414.000083
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