Optic nerve lesions interfering visual pathway

The optic nerve is also named the cranial nerve that starts from the optic disc and extends up to the optic chiasma. Blindness and visual defects are caused when there is a lesion in the optic nerve.

Causes: Head injury, optic atrophy, optic neuropathy are the primary causes of lesions inside the optic nerve.

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Symptoms: Lesions that happen in the entire optic nerve causes blindness on the affected portion of the eye. This means that the person loses all his or her vision in that part of the eye. Tunnel vision and optic neuritis are other signs of this condition.

Lesions of an optic chiasm:
The optic chiasma is a portion of the brain that contains crossings of both the optic nerves. It is situated at the bottom region of the brain next to the hypothalamus and below it. All the symptoms and the signs that are manifested with the lesion of optic chiasma is called a chiasmal syndrome.

Causes: There are intrinsic and extrinsic factors that act as causative agents to bring about lesions in the optic chiasma. Extrinsic factors are the structures that compress the optic chiasma. Intrinsic factors are caused by the chiasma which thickens.

Symptoms The symptoms of the lesions in the optic chiasm are nasal field disruption of both eyes. This results in eyesight loss in either the right eye or even in half of the visual field of the right eye. It can happen in both eyes or a single eye. This visual field defect is called bitemporal hemianopia. When the lesion destroys the optic nerve fibers and also the inferonasal fibers, it results in anterior chiasmal syndrome. These fibers are situated in the knee and generate scotoma. Therefore, the synthesis of scotoma will also be affected.

Optic tract lesions:
The optic nerve continues with the optic tract to conduct the signals from the optic chiasm to the lateral geniculate nucleus, superior colliculus, and pretectal nuclei. The optic tract denotes the first step in the visual pathway where the visual information is moved to the homonymous nature.

Causes: There are intrinsic and extrinsic causative factors for optic tract lesions. Any form of demyelinating infarction and diseases serve as intrinsic factors. Craniopharyngioma or tumors of the optic thalamus serve as extrinsic factors. Gumma, syphilitic meningitis, and tubercular meningitis are other causative conditions for optic tract lesions.

Symptoms: When shown the light in the eye, there will not be any pupillary reaction. If the light is directed to the seeing half, there will be a response from the pupil. This is known as Wernicke’s pupillary reaction. Homonymous hemianopia is one of the other symptoms of optic tract lesions

Optic radiation lesions:
The optic radiation consists of the axons that come from the neurons in the later geniculate nucleus and stops in the visual cortex region.

Causes: Posterior cerebral artery and middle cerebral artery infarction can impact the optic radiations and results in lesions.

Symptoms : Lesions in the right side of the temporal lobe of the optic radiation generate a loss of outer quadrant vision and loss of upper vision of the same portion of the eye. This is called superior quadrantanopia or hemianopia. This is also called a pie in the sky disorder.

Visual cortex lesions:
The visual cortex is situated in the occipital lobe and cerebral cortex portion of the brain that regulate the visual information and helps in the conductance. When there is complete or partial blindness in the visual cortex of the brain, then it is called cortical blindness.

Causes: Gunshot, head injury, eclampsia, meningitis, and other medications might result in cortical blindness.

Symptoms: Optical cortical lesions result in hemianopias of different sizes along with macular involvement. Homonymous hemianopia with the involvement of macular sparing is one of the characteristic features of the optical cortical lesions and the defect of the anterior portion of the visual cortex.

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