Quadrantanopia

What is quadrantanopia?

Quadrantanopia is a medical term that means you have a loss of vision in one quarter (one-fourth) of your visual field. You can divide your visual field into four parts or quadrants.

You have a right and left quadrant on the top and a right and left quadrant on the bottom. Quadrantanopia means that you can’t see out of one of those spaces. They appear to be blacked out.

If you can’t see out of one half of your field of vision, you have hemianopia. “Anopia” means the absence of vision, or blindness. The “hemi” means one-half and the “quadrant” means one-fourth.

Another name for quadrantanopia is quadrantopsia.

Are there types of quadrantanopia?

There are different types of quadrantanopia depending on which quadrant is affected.

• If you have loss of vision in the same quadrant of both eyes, you have homonymous quadrantanopia.
• Loss of vision can affect the upper (superior) quadrants in the left-hand quadrant or the right-hand quadrant.
• Loss of vision can affect the lower (inferior) quadrants in the left-hand quadrant or the right-hand quadrant.
• Binasal quadrantanopia affects the upper or lower quadrants closest to your nose.
• Bitemporal quadrantanopia affects the upper or lower quadrants farthest from your nose and closest to your temples.

Another term for a homonymous superior quadrantanopia is “pie in the sky” quadrantanopia. Another term for loss of vision in the lower quadrants is “pie on the floor” quadrantanopia.

What are the signs and symptoms of quadrantanopia?

The main sign of quadrantanopia is losing vision in one-fourth of your visual field.

You may find yourself moving your head around to compensate for the loss of vision. It may seem to you that objects appear suddenly, or you may bump into or trip over things.

What causes quadrantanopia?

A disturbance in the visual pathways between the eyes and the brain causes quadrantanopia. Electrical signals travel along the optic nerve to get to your brain.

Causes of such damage may include:

• A stroke.
• Tumors.
• Traumatic brain injury.

It’s possible for you to have vision loss on one side that causes damage on the opposite side. The term for this is contralateral damage.

How is quadrantanopia diagnosed?

Your eye care specialist will conduct certain tests to diagnose any eye condition, including taking a medical history and doing an eye exam.

Other tests include:

• Visual field testing: This test examines your visual field, the entire area that you see. It tells you how far up, down, left and right your eyes see without moving and how sensitive your vision is in different parts of the visual field.
• Ophthalmic electrophysiology: These tests measure how different parts of your vision system respond to light. One of these tests is an electroretinogram.

How is quadrantanopia treated?

Your vision may improve spontaneously, but that usually happens within three to six months. If recovery doesn’t happen, you may be able to manage symptoms.

A healthcare provider may suggest visual rehabilitation strategies to help you compensate for loss of vision. These strategies may include:

• Learning to move your head more often and quickly to deal with the blind spots.
• Using line guides and bright markers to help with reading.
• Using a computer-based treatment that stimulates the blind spots.

How can I reduce my risk of developing quadrantanopia?

You can do things that help you reduce your risk of stroke and traumatic brain injury. These things would then reduce your risk of losing one-fourth of your visual field.

To reduce your risk of stroke, you can:

• Eat a healthy diet that includes a variety of foods that are low in saturated fat, salt and cholesterol.
• Achieve and maintain a healthy weight.
• Engage in regular physical activity.
• Limit your alcohol intake.
• Quit smoking and using tobacco products. Talk to your healthcare provider about ways you can quit.

To reduce your risk of traumatic brain injury, you can:

• Practice safe driving by using your seat belt and not driving under the influence of drugs or alcohol. Don’t use your cell phone while driving.
• Use protective equipment if you need it for work or sports, including helmets.
• Arrange your house to prevent falls. Make sure the steps are clear and the lighting is good.
• Get your eyes checked regularly.

Review your medicines and supplements regularly to find out if any of them make you dizzy.

What can I expect if I have quadrantanopia?

There’s no cure for quadrantanopia, but it may improve or potentially resolve on its own. In some cases, you may find that you’re still able to do most things that you’re used to being able to do.

If vision loss remains, your provider may suggest you take advantage of resources that’ll help you deal with these changes.

When should I seek care for quadrantanopia?

Always contact a healthcare provider if you have vision loss. Get immediate medical help if you think you may have had a stroke or if you’ve had a traumatic brain injury. These injuries are ones that happen in car accidents, work accidents or other reasons you may get blows to the head or puncture wounds.

What questions should I ask a healthcare provider?

If you have quadrantanopia, you may want to ask these questions or ones like them:

• What resources can you suggest to help me deal with loss of vision?
• Am I eligible to participate in any clinical trials?
• Is there a food plan you suggest?
• What can family and friends do to help me deal with this or to get support for themselves?
• Can I get tested to make sure I can drive safely?

A note from Cleveland Clinic

It’s always best to have any vision changes evaluated. If you’ve had a stroke or a brain injury, your healthcare provider will do an examination at that time. Let them know immediately if you have any difficulty seeing, or if you feel like one eye isn’t working. Continue to get exams as needed and to follow the recommendation of the healthcare team. Feel confident in asking questions and getting the answers you need.