I Can’t See The Whole Picture!


A scotoma is Greek for darkness, is an area of partial alteration in one’s field of vision consisting of a partially diminished or entirely degenerated visual acuity which is surrounded by a field of normal – or relatively well-preserved – vision. It is also an area of the retina in which there are few or no cones or rods, the specialized nerve cells that convert light signals to nerve impulses, creating a blind spot in the visual field.

Scotoma is a common type of vision loss after stroke or traumatic brain injury, a scotoma is an island of visual field loss or impaired vision surrounded by relatively normal vision. We all have the physical ones in our eyes that we normally don’t notice. However, a wide range of diseases and injuries can cause a pathological scotoma. For example, a scotoma can be a sign of optic nerve damage sustained during a stroke or brain injury.

The main symptom of scotoma is one or more dark, light, or blurred areas in the field of vision. Those affected by visual field loss may also experience a need for greater illumination and contrast when reading, and may have difficulty perceiving certain colors.

A scotoma may occur in any shape or size, and it may affect any portion of the visual field. In some cases, a scotoma will include and enlarge the blind spot occurring naturally in a person’s eye. The main types of scotomas include:

Central scotoma: an area of decreased or lost vision that interferes with central vision (likely to affect daily life)

Hemianopic scotoma: an area of decreased or lost vision that affects half of the central visual field

Peripheral scotoma: an area of decreased or lost vision toward the edge of the visual field (less likely to affect daily life)

Pareacentral scotoma: An area of decreased or lost vision near, but not in the central vision.

Scotomas cannot be treated in most cases, but it is still important to seek care from an ophthalmologist if a scotoma appears, because it can indicate a serious problem. Treatment can be used to prevent the spot from growing larger, and to address the underlying issue which led to the development of the scotoma.

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