Lesions at the level of the optic chiasm
Lesions at the level of the optic chiasm result in a bitemporal hemianopia.
Tumours of the pituitary may initially present with a bitemporal upper quadrantic defect which progresses to a bitemporal hemianopia.
This is because they only interfere with the decussating fibres, which are those fibres from the nasal retina that sense images from the temporal visual field.
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