Visual field defects in onchocerciasis.

Lesions in the posterior segment of the eye in onchocerciasis may give visual field defects, but so far no detailed investigation has been done to determine the functional visual loss. Examination of the visual fields in 18 selected cases of onchocerciasis by means of a tangent screen test revealed important visual field defects associated with lesions in the posterior segment of the eye. Involvement of the optic nerve seemed to be important, giving rise to severely constricted visual fields. Cases of postneuritic optic atrophy showed a very uniform pattern of almost completely constricted visual fields, with only 5 to 10 degree central rest spared. Papillitis gave a similar severe constriction of the visual fields. The pattern of visual fields associated with optic neuropathy in onchocerciasis indicates that a progressive lesion of the optic nerve from the periphery may be responsible for the loss of vision. The visual field defects in onchocerciasis constitute a serious handicap, which must be taken into consideration when estimating the socioeconomic importance of the disease.