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# Visual cortex

The visual cortex lies on the inner surface of the [occipital lobe](https://durgical.com/en/anatomy/superior-occipital-gyri/) at the back of the brain; it is the first cortical stop for vision from both eyes.

Official name: Cuneus

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## What it is

The cortex around the calcarine sulcus on the inner surface of the occipital lobe.

## What it does

First cortical stop for vision; a stroke here blanks half the visual field of both eyes.

## Key points

- Retinotopic map: the upper visual field lands on the lower bank (lingual gyrus), the lower field on the upper bank (cuneus); central vision has a large area at the occipital pole
- Each side receives the opposite half of the visual field from both eyes: damage gives a contralateral homonymous hemianopia, usually congruous, often sparing the [macula](https://durgical.com/en/anatomy/macula/)
- A lesion of one bank gives a quadrant defect: upper bank (cuneus), inferior quadrantanopia; lower bank (lingual gyrus), superior quadrantanopia
- Also called striate cortex, after the stria of Gennari, a band of myelinated fibres in layer IV visible to the naked eye

## Key facts

**Where**
Banks of the calcarine sulcus (occipital)

**Blood supply**
PCA (calcarine branch)

**Function**
Primary visual cortex (area 17); opposite visual field

## Relations

**Course**
Input from the [lateral geniculate body](https://durgical.com/en/anatomy/lateral-geniculate-body/) through the optic radiation: upper fibres through the [parietal lobe](https://durgical.com/en/anatomy/superior-parietal-lobule/), lower fibres around the temporal horn (Meyer loop)

**Above**
Cuneus, above the calcarine sulcus

**Below**
Lingual gyrus, below the calcarine sulcus

**In front**
Junction with the parieto-occipital sulcus; the splenium of the [corpus callosum](https://durgical.com/en/anatomy/corpus-callosum/) lies just in front

**Behind**
Occipital pole, where the macular area may reach onto the lateral surface

## How to find it

It lines the calcarine sulcus on the medial surface of the occipital lobe, from the occipital pole forward to where the sulcus meets the parieto-occipital sulcus. Sagittal and coronal MRI show it best; most of it is buried in the walls of the sulcus.

## Examination

- Confrontation fields and formal perimetry: a congruous homonymous defect with macular sparing suggests an occipital lesion
- Pupillary light reflex: normal in cortical blindness, because the reflex fibres leave the optic tract for the [midbrain](https://durgical.com/en/anatomy/midbrain/) before the geniculate body

## On imaging

Sagittal and coronal MRI show the calcarine sulcus and its two banks. A [posterior cerebral artery](https://durgical.com/en/anatomy/posterior-cerebral-artery/) infarct is bright on DWI in the medial occipital lobe and matches a homonymous hemianopia; a spared occipital pole can explain macular sparing. CT shows bleeds and older infarcts. Symmetric parieto-occipital oedema on FLAIR suggests posterior reversible encephalopathy syndrome (PRES).

## Clinical notes

- Visual migraine aura, a shimmering zigzag that spreads over minutes, is attributed to a wave of spreading depression across the visual cortex
- Anton syndrome: bilateral damage with cortical blindness that the person denies, describing scenes that are not seen

## Memory aid

The cuneus sits upstairs and sees the floor; the lingual gyrus sits downstairs and sees the sky.

## Related conditions

- [Migraine](https://durgical.com/en/conditions/migraine/)
- [Strabismus and amblyopia](https://durgical.com/en/conditions/strabismus-and-amblyopia/)

## Test yourself

Think of the answer, then tap the question to see it.

## Where is the primary visual cortex?

Lining the calcarine sulcus on the medial surface of the occipital lobe (area 17), from the occipital pole forward.

## Which bank of the calcarine sulcus receives the upper visual field?

The lower bank (lingual gyrus); the upper bank (cuneus) receives the lower field, so a cuneus lesion gives an inferior quadrantanopia.

## Why is the visual cortex called striate cortex?

After the stria of Gennari, a band of myelinated fibres in layer IV visible to the naked eye.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
cuneus TA2 5485

**Official Spanish (DeCS)**
Corteza Visual Primaria DeCS D000087642

**English (TA2)**
Cuneus

**Also called**
striate cortex · V1

## Related

- [Posterior cerebral artery](https://durgical.com/en/anatomy/posterior-cerebral-artery/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=59652&filter=ths_termall&q=Primary%20Visual%20Cortex); [Neuroanatomy, Visual Cortex](https://www.ncbi.nlm.nih.gov/books/NBK482504/).

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Source: https://durgical.com/en/anatomy/cuneus/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/cuneus/