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Abstract Details

Hemifield Slip Phenomenon after Traumatic Chiasmopathy
Neuro-ophthalmology/Neuro-otology
P02 - (-)
262
BACKGROUND: Hemifield slip phenomenon is a rare occurrence where fusion of overlapping visual fields is lost, resulting in diplopia and 'slipping' of images. Diplopia following trauma affecting the middle cranial fossa can due to contusion of cranial nerves, increased intracranial pressure, or dural fistulas. Hemifield slip phenomenon has not previously been reported as a cause of diplopia in post-traumatic chiasmopathy.
DESIGN/METHODS: This is a case report.
RESULTS: A 56 year old man with no prior medical problems suffered a closed head injury after a motor exploded and knocked him unconscious. He suffered facial and skull fractures, including dehiscence of bone at the planum sphenoidale and tuberculum sellae, complicated by a cerebrospinal fluid leak. After awakening from the injury, he reported blurry vision and diplopia. Examination revealed 20/200 vision in the right eye and 20/25 vision in the left eye. He had a bitemporal hemianopia on Goldmann kinetic visual field testing, an afferent pupillary defect in the right eye, and bilateral optic atrophy. Eye movement testing revealed no ophthalmoplegia. He was able to read, but only for a few words because the letters 'become jumbled together', or slid past each other.
CONCLUSIONS: This is the first case of a patient with hemifield slip associated with post-traumatic chiasmopathy. Patients with hemifield slip phenomenon can learn coping maneuvers to improve their visual quality of life, such as prisms or placeholding tools for reading. Our case highlights the need for a complete neuro-ophthalmologic evaluation in patients with a post-traumatic visual disturbance, as they may harbor multiple problems with distinct treatments.
Authors/Disclosures

PRESENTER 		No disclosure on file
Jorge C. Kattah, MD, FAAN (University of Illinois College of Medicine at Peoria) Dr. Kattah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Bonezzi, Switzer , Poilitto and Hupp Legal Firm.
John Pula, MD, FAAN (NorthShore University HealthSystem) Dr. Pula has nothing to disclose.
Edward Fox, MD, PhD, FAAN Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion Pharmaceuticals. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GW Pharmaceuticals. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Fox has received research support from Biogen. The institution of Dr. Fox has received research support from Genentech. The institution of Dr. Fox has received research support from Celgene - BMS. The institution of Dr. Fox has received research support from Chugai. The institution of Dr. Fox has received research support from Novartis. The institution of Dr. Fox has received research support from EMD-Serono. The institution of Dr. Fox has received research support from TG Therapeutics. The institution of Dr. Fox has received research support from AbbVie. The institution of Dr. Fox has received research support from Sanofi Genzyme. The institution of Dr. Fox has received research support from AbbVie.