Peripheral Visual Field Loss

CLINICAL DIAGNOSTIC MANUAL

Peripheral visual field loss, also known as tunnel vision, can significantly impact a person’s quality of life by limiting their ability to navigate safely and perform daily activities.

This condition can be caused by various pathologies affecting the retina, optic nerve, optic chiasm, optic tract, or visual cortex. Accurate assessment of the underlying cause is crucial to determine the appropriate treatment and prevent further vision loss.

Condition	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Functional psychogenic disorder	Peripheral vision loss without objective findings, fluctuating symptoms, associated anxiety or stress	History of visual symptoms unexplained by objective findings	Psychiatric evaluation, exclusion of organic causes
Retinitis pigmentosa	Progressive peripheral vision loss, difficulty seeing in the dark, retinal pigment changes	Family history of retinitis pigmentosa, progressive visual symptoms	Fundoscopic exam showing pigment deposits, ERG
Chorioretinitis	Peripheral vision loss, blurred vision, spots in the visual field, possible eye pain	History of infections or autoimmune diseases, inflammatory symptoms	Fundoscopic exam, OCT, fluorescein angiography
Optic chiasm lesion	Bitemporal vision loss, bilateral visual field defects	History of bilateral visual symptoms, associated neurological signs	Brain MRI showing optic chiasm lesion
Optic tract lesion	Homonymous vision loss, contralateral visual field defects	History of stroke or trauma, neurological symptoms	Brain MRI showing optic tract lesion
Visual cortex lesion	Homonymous vision loss, visual perception changes	History of stroke, trauma, or tumours, neurological symptoms	Brain MRI showing lesion in the visual cortex