is bitemporal hemianopia which obeys the midline (the hemianopia may be
worse in one eye than the other or denser superiorly or inferiorly). This
suggests a lesion in the optic chiasm.
In the examination:
The hemianopia may be subtle and revealed only by comparing
two red objects in each hemifield. The red colour in the temporal field
appears washed out.
If the hemianopia does not obey midline consider pseudo-bitemporal
hemianopia such as bilateral sectorial retinitis pigmentosa, tilted discs
or bilateral inferotemopral retinoschisis. Mention that you would like
to examine the fundi for any such changes.
Features of pituitary abnormalities such as acromegaly, pan-hypopituitarism
(smooth skin and absence body hair in male)
Look for any scar suggestive of pituitary operation.