Final answer:
Approach patients with decreased field of vision, like those with bilateral hemianopia, on the side where their visual perception is intact, due to how optic nerve fibers cross at the optic chiasm and project visual information to the brain.
Step-by-step explanation:
Patients with a decreased field of vision, such as bilateral hemianopia, should ideally be approached on the side where their visual perception is intact. In cases like these, damage to the optic chiasm, often due to a pituitary tumor, affects the crossing of optic nerve fibers. The result is the loss of peripheral vision from the opposite side of the affected visual field. Therefore, when interacting with patients who have bilateral hemianopia or similar conditions, one should approach them from the side that corresponds to their intact visual field. For context, within each eye, the axons projecting from the medial side of the retina decussate at the optic chiasm and carry information from the peripheral visual field to the opposite side of the brain. Conversely, the axons from the lateral side of the retina project to the same side of the brain. Thus, a patient with loss of peripheral vision on one side retains central vision and peripheral vision on the contralateral side. This needs to be considered when approaching such patients to ensure better communication and to avoid startling them.