Scotoma

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Related to ring scotoma: paracentral scotoma, scotomata

scotoma

[skə′tō·mə]
(medicine)
A blind spot or area of depressed vision in the visual field.

Scotoma

 

a blind area within the visual field, not affecting the surrounding area of the eye. Physiologic scotoma is that area of a healthy eye’s visual field corresponding with the optic disk, which does not have photoreceptors. Pathologic scotoma is a diagnostic symptom of many diseases, including retinitis and atrophy of the optic nerve. It is perceived as a dark spot (positive scotoma) or as a blank spot (negative scotoma) that can be detected only through special testing. During teichopsia (scintillating scotoma), which lasts 20–30 minutes, flickering is perceived along the eye’s periphery; the condition is usually accompanied by persistent headaches, nausea, and vomiting. Treatment of scotoma is directed toward the underlying disease.

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Patients with ring scotomas generally have near-normal acuity (Maguire & Vine, 1986; Moil et al., 2001; Rotenstreich, Fishman, & Anderson, 2003), which does not reflect their functional impairment in reading and activities of daily living (Fletcher & Schuchard, 1997; Sarks, Sarks, & Killingsworth, 1988; Sunness et al., 1999; Sunness, Rubin, Zuckerbrod, & Applegate, 2008).
The most essential issue for successful intervention for ring scotomas is that both the clinician and the patient are aware of the visual pattern and its clinical significance.
Of interest is that 8 of the 9 eyes with the macular ring scotoma remained in that configuration throughout the follow-up period.
Figure 4 shows a patient with a macular ring scotoma from Stargardt disease whose reading rate was measured for larger letter sizes.
In this report, we describe the case of a patient with macular disease whose relatively good visual acuity was maintained but whose fixation was surrounded by a ring scotoma. The patient experienced considerable difficulty maintaining an independent lifestyle, and many of the subject's activities of daily living were disrupted.
Foveal fixation was present in his good left eye surrounded by a complete ring scotoma. Figure 1 shows the image obtained by SLO.
Coffee and doughnut maculopathy: a cause of acute central ring scotomas. Br J Ophthalmol 2000; 84: 158-64.
A 57-year-old Caucasian male presented with a ten-year history of nonprogressive ring scotomas OU (Figure 1).
Ring scotomas, with their particular rehabilitation challenges (Schoessow, Gilbert, & Jackson, 2010) continue to be common.
When correcting refractive error, full aperture lenses must be used since reduced aperture lenses can simulate tunnel vision and induce peripheral ring scotomas. It is appropriate to use a patient's own spectacle correction, but only if it is a single vision lens and with a depth that will not induce rim artefacts.