Article

CLINICAL: Case Scenario

Left Side Visual Field Loss

Confrontation visual fields and 30-2 threshold visual field test aid in diagnostic process.

“Case Scenario,” illustrates how a specific device’s image(s) aided in patient management.

PATIENT

A 63-year-old “light”-smoking Caucasian male, reporting loss of side vision, particularly on the left side OS, and flashing lights for about two days.

EXAM FINDINGS

BCVA: 20/30 OU at distance; confrontation VF screening displayed left VF loss OU; FDT VF screening abnormal with loss concentrated on the left side OU, slightly sparing superior left VF OU.

APPROACH

Dilated fundus exam, retinal imaging and central 30-2 threshold Humphrey VF test.

DIAGNOSIS

Homonymous VF defect, due to interruption in the right optic tract, optic radiations in the right parietal lobe or right occipital lobe and mild vitreous degeneration with a moderate amount of floaters.

MANAGEMENT

Referral for brain MRI to check for abnormalities in the right side of the brain

PATIENT CARE TIP

Utilize FDT and confrontation VFs to specify VF loss and for patient education.

CODING

92004, 99250, 92083, G8427, and G9902 OM

CASE STUDY

Central 30-2 threshold VF test showing left homonymous hemianopsia OU, with mild sparing of the superior nasal visual field OD.

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