In (b)(4) 2014 - the patient was implanted with the rns system.The neurostimulator was placed in the left temporal region with (1) depth lead (44cm, 10 mm) in l hippocampus, (1) depth lead (44cm, 3.5mm) in l amygdala.Patient first reported blurriness in his right lower visual field.The neurosurgeon noted "difficulty in right field of vision." patient continued to report persistent blurriness in right inferior quatrad and some troubles reading.The neurologist noted in clinic note that "he does not have a frank field cut." in (b)(6) 2014 - he was seen formally by the ophthalmologist.Ophthalmologist clinic note that there is an "area of vision loss and positive visual phenomenon.Area is close to natural blind spot but larger." in (b)(6) 2015 - the patient mentioned he was seeing an eye doctor about experiencing a visual field reduction after his implant.His condition has stayed the same.Physician adjusted the neurostimulator stimulation parameters to improve his efficacy as he is responding but not with the intent to effect his vision.Medications have remained stable and not changed during this time period.Of note is that the hippocampal depth lead used an occipital approach for placement.It is a possibility that this may have contributed to the event, but we have no information on certainty.
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