Unusual spontaneous and training induced visual field recovery in a patient with a gunshot lesion

Over a period of more than 3 years, changes in visual and neuropsychologica l functions were examined in a patient with a visual field defect caused by a cerebral gunshot lesion. Initially, the patient had been completely blin d, but after 6 months of spontaneous recovery, he showed a homonymous bilat eral lower quadrantanopia and impairment of higher visual functions. Unexpe ctedly, recovery still continued after the first 6 months. This process was documented in detail by visual field examinations using high resolution pe rimetry. When visual field size had stabilised almost 16 months after the l esion, further improvement could be achieved by visual restitution training . The duration and extent of spontaneous recovery were unusual. In spontane ous as well as in training induced recovery, progress was mainly seen in pa rtially defective areas (areas of residual vision) along the visual field b order. Thus, it is speculated that modulation of perceptual thresholds in t ransition zones of visual field defects contributes to spontaneous and trai ning induced recovery.