It is well recognised that a prematurely born child can present with problems in adult life.1 Here we present two cases with repeatable visual field defects noticed on routine visual field assessment at the optician. No immediate cause was apparent, but extensive history-taking revealed premature birth in both cases.

A 35-year-old woman was noted to have a repeatable visual field defect on routine visual field testing at the optician. She was referred to the hospital by her general practitioner for the same problem. Her visual acuity was 6/6 right and 6/5 left with correction. No significant past ocular or general medical history was present and she did not have any history of familial disease. On examination her pupils were normal. Her ocular movements were full. She was orthophoric. Threshold visual field testing on the Humphrey automated visual field analyser showed repeatable field defects suggesting right homonymous hemianopia. Dilated fundus examination did not show any abnormality. A CT scan showed ill-defined areas of low attenuation close to the inferior horn of the left lateral ventricle, indistinguishable from its margin and not associated with any mass effect. There was no lesion enhancement on contrast. A subsequent MRI scan showed high signal on the FLAIR, axial and T2-weighted images, extending away from the left lateral ventricle towards the periventricular white matter. It was poorly defined and did not appear to cause any mass effect. There was a minor enlargement of the left lateral ventricle. It was suspected to be focal damage involving the internal capsule, particularly the anterior limb, genu, globus pallidus and caudate nucleus tail. The pattern was consistent with either a haemorrhage or infarction in early life. It was likely that the optic radiation was interrupted close to the lateral geniculate body.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account
Continue with Google
Continue with ORCiD