Central Scotoma, Centrocecal Scotoma
These visual field defects are typical of retinal or optic nerve pathology. They may be mapped by confrontation testing or automatically.
- Central scotoma:
- Field defect occupying the macula, due to involvement of the macula or the papillomacular bundle; this is the typical (but not exclusive) finding in optic neuritis, but may also be seen with disease of the macula, optic nerve compression, Leber’s hereditary optic neuropathy. Examination for a concurrent contralateral superior temporal defect should be undertaken: such junctional scotomas may be seen with lesions at the anterior angle of the chiasm.
- Centrocecal or cecocentral scotoma:
- Field defect involving both the macula and the Blind spot; seen in optic nerve disease, such as Leber’s hereditary optic neuropathy, toxic or nutritional optic neuropathies (said to be typical of vitamin B12 deficiency optic neuropathy), sometimes in optic neuritis.