Manual
Confrontation visual fields
The Eye Exam
Confrontation visual fields
Quick screening for hemianopias and altitudinal loss.
- 1Sit 1 m away at eye level; patient covers one eye and looks at your nose.
- 2Present 1, 2 or 5 fingers in each quadrant, midway between you.
- 3Compare hemifields with simultaneous finger presentation (extinction).
- 4Red-cap comparison across the vertical meridian for subtle chiasmal defects.
| Defect | Lesion |
|---|---|
| Monocular | Retina / optic nerve |
| Junctional scotoma | Optic nerve–chiasm junction |
| Bitemporal hemianopia | Chiasm (pituitary) |
| Homonymous, incongruous | Optic tract |
| Superior quadrantanopia ('pie in the sky') | Temporal lobe (Meyer loop) |
| Inferior quadrantanopia | Parietal lobe |
| Congruous hemianopia ± macular sparing | Occipital lobe |
Educational summary — follow local protocols and current guidelines.