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Homonymous Hemianopia
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Homonymous Hemianopia


  My wife, who is 36,  had a left temporal labectomy on 21 August.  This was the second operation, the first was June last year but after this she was still having epeleptic seizures, albeit of a more minor nature, an MRI showed that they had left some and recommended the second operation stating the chances of success were very good.  During the evening after the operation she had a vasospasm, I am told this was a minor stroke. There was right side weakness, but after rehabilitation this is nearly back to normal.  She also has lost the vision in the right half of each eye, Homonymous Hemianopia.  My wife has had a number of visual feild tests, these have shown that the compete right side of the eye is impared and we have been told this is permanent and nothing can be done.  We have also been told prisms and reflactive glasses would be of little help.  Considering Hemianopia is not uncommon in stroke victims I would like to know is there any chance of improved vision.  Where is the current research being done into Homonymous Hemianopia (We will travel) and how long does it look like before this can be treated.
  Thank You
  Scott Burcham
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Homonymous Hemianopia is a defect in one's visual fields because of a disruption of the visual tracts anywhere along a long pathway that includes the brain from the temporal lobes to the back of the brain in the occipital lobes.  In your wife's case it may have been caused by the operation of the temporal lobe depending on the extent of tissue removed or the stroke that you describe depending on its location - in either case it is a phenomenom caused from destruction of a portion of the brain.  Some recovery may be possible depending on the the extent of the lesion by adjacent areas basically picking up the slack.   So there may be some recovery - there may be none - but if it occurs it would have to occur on it's own and would occur offer weeks to months at the longest. After that spontaneous recovery doesn't occur.  As for research, I don't think much is going on in the field of recovery of field defects - in general, more functionally severe defects are the better studied (i.e. weakness, language problems).Perhaps an ophthalomologist would no better.  Some studies have been done re: compensating for the field defect - the use of Fresnel prisms come to mind.  But although patients using Fresnel prisms scored better on some visual tests in a 1990 study, they did not perform any differently in their activities of daily living.  An ophthalomologist may know better but, unfortunately, your doctors may be describing an accurate scenario.





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