Visual Field Defects Due to Optic Nerve Compression by Mass Lesions

In 1893, Gowers1gave unilateral loss of sight and of smell as a lateralizing sign of frontal tumor. In 1905, Schultz-Zehden2published a clinical and postmortem report of a frontal tumor with profound optic atrophy in one eye and severe papilledema in the other. He stated, "We have before us in the foregoing case, a double action by the tumor. In the one eye it led to atrophy by direct compression of the optic nerve; in the other it acted directly to destroy it by raising the intracranial pressure." In 1906, Wilbrand and Saenger3reported a similar case and explained that the absence of papilledema in the atrophic nerve head was due to the shutting off by the tumor of the meningeal spaces, thus preventing the cerebrospinal fluid from circulating into the optic nerve sheath on that side. In 1909, Leslie Paton4wrote his famous paper