Restitution of visual function in patients with cerebral blindness

Abstract

Patients with postchiasmatic visual field defects were trained at the border of their visual field. Using a psychophysical method, light-difference thresholds were determined repeatedly in this visual field area. Improvement in contrast sensitivity and increase in size of the visual field could be obtained by this training procedure. The improvement was confined to the trained visual field area and showed interocular transfer indicating its central nature. Althoughh only contrast sensitivity was trained, the observed improvement was not limited to this visual function. Visual acutity, critical flicker fusion, and colour perception also showed and improvement suggesting an association of these functions. The improvement was restricted to the training period-no spontaneous recovery was observed between or after the periods of training. It is suggested that a lesion in the central visual system does not always result in a complete and permanent loss of function. The critical level of function that normally has to be reached for sufficient neuronal sensitivity may be obtained by systematic visual stimulation in the area between the intact and blind parts of the visual field. This increase in neuronal sensitivity leads to an improvement in visual performance.