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    By Andrew G. Lee, MD; Karl C. Golnik, MD
    Committee on Aging
    Comprehensive Ophthalmology, Neuro-Ophthalmology/Orbit

    This podcast series from the Academy's Committee on Aging features leading experts who discuss clinical experiences and the differences in caring for older adults.

    In today's podcast, Dr. Karl Golnik reviews his approach for differentiating and managing unilateral, bitemporal, and homonymous hemianopsias. In the case of a unilateral defect, the clinician should look for the presence of optic nerve or retinal problems. In the elderly patient, an ischemic optic neuropathy must be strongly suspected. In the case of a bitemporal defect, the most likely cause in this age range is compressive lesion. Finally, a homonymous hemianopsia, either acute or chronic, requires imaging with MRI and strong suspicion of stroke, especially in the elderly.