Scotoma (Blind Spot): Causes, Symptoms, and Diagnosis
A scotoma is felt as a spot in the visual field where the image disappears. It may also darken or become less clear. A person may see the blind spot in the center, to the side, or only notice it when reading, driving, or working on a screen.
Scotoma is a symptom, not a diagnosis in itself. It can be associated with the retina, optic nerve, glaucoma, vascular disorders, or migraine with aura.
specialists
equipment
treatment
Causes of scotoma
The retina and optic nerve are involved in image transmission. If the macula, blood vessels, nerve fibers, or optic disc are damaged, visual loss occurs. Causes include inflammation, edema, hemorrhage, optic neuritis, and retinal detachment.
Glaucoma and Vascular Disorders
Glaucoma can damage the visual field undetected for a long time. Peripheral defects are sometimes only detected by perimetry. Vascular disorders, thrombosis, and ischemic processes can also cause scotomas, so an assessment of the fundus and pressure is important.
Migraine with Aura and Neurological Causes
Migraine with aura sometimes causes temporary flickering spots, zigzags, or loss of part of the image. However, even if the symptom resembles a migraine, a new or recurring scotoma should be discussed with a doctor. If you experience weakness, speech impairment, coordination problems, or severe headaches, seek immediate assistance.
Symptoms you shouldn't ignore
Now let's take a closer look at the signs of this pathology.
Spot, fog, or loss of a portion of the image
The patient may describe the scotoma in various ways: a spot, fog, a blank space, or an area that is "unreadable." Sometimes the visual field defect is only noticeable when closing one eye. Any new loss of the visual field requires diagnosis.
Flashes, distorted lines, pain, headache
Flashes, lightning, distorted straight lines, eye pain, or severe headache help the doctor understand the possible source of the problem. If accompanied by a sudden decrease in vision, an examination should not be delayed.
When scotoma is associated with a sudden deterioration in vision
A sudden scotoma with a curtain, flashes, or pain may be a sign of an acute condition. In this situation, a scheduled appointment should not be delayed. An urgent examination is needed to rule out retinal detachment, vascular disorders, or inflammation of the optic nerve.
General information
Types of Scotoma
Now let's take a closer look at the types of this pathology.
Central Scotoma
Central scotoma affects the area in front of the point of gaze. The patient has difficulty reading, distinguishing faces, and seeing small details. Possible causes include macular disease, optic neuritis, and vascular disorders.
Peripheral Scotoma
Peripheral scotoma occurs to the side of the center of the visual field. A person may not immediately notice it, especially if the other eye compensates for the defect. This pattern is common with glaucoma, optic nerve damage, retinal detachment, and other conditions.
Absolute and Relative Scotoma
Absolute scotoma means complete loss of vision in the area. Relative scotoma is a decrease in brightness or clarity, when the image does not disappear completely. For the physician, it's not just the complaint that's important, but also the precise map of the defect provided by perimetry.
Positive and Negative Scotoma
The patient can see a positive scotoma: a dark spot, flickering, or a "hole" in the image. A negative scotoma may not be felt and is only detected during examination. Therefore, diagnosing scotoma is important even in cases of unclear complaints.
Types of scotoma
| Type of scotoma | How it manifests | Possible causes | What we usually check |
|---|---|---|---|
| Central scotoma | Image loss in the center | Problems with the macula or optic nerve | Vision examination, fundus examination, OCT, perimetry |
| Peripheral scotoma | Loss of areas sides | Glaucoma, retinal detachment, nerve damage | Perimetry, IOP measurement, fundus examination |
| Absolute scotoma | Complete loss of vision in the area | Severe retinal or nerve damage | Perimetry, OCT, additional diagnostics |
| Relative scotoma | Decreased brightness or clarity | Early stages of glaucoma, neuritis | Threshold perimetry, OCT |
| Positive scotoma | The patient sees spot | Hemorrhage, retinal lesion | Ophthalmoscopy, OCT |
| Negative scotoma | Detected during examination | Optic nerve disease or cortical disorders | Perimetry, neurologist consultation if indicated |
We combine examination, perimetry, OCT, and fundus evaluation into a logical process. The patient is not left with a set of confusing results.
Accurate interpretation of results
These examination data are only important in conjunction with the clinical picture. The ophthalmologist compares the patient's complaints, visual field map, macula, optic nerve, and overall condition.
A clear plan of action
After the examination, the patient receives an explanation: what was found, what was excluded, and whether follow-up, treatment, or consultation with another specialist is necessary.
Prevention and monitoring
Regular eye examinations are helpful for glaucoma, diabetes, vascular diseases, migraines with aura, and previous eye inflammations. They help detect changes before the patient notices significant defects.
Regular vision screening in risk groups
The doctor determines the frequency of screenings individually for risk groups. It is important to not skip perimetry and OCT scans if they are prescribed for monitoring.
Frequently Asked Questions
What is a scotoma in simple terms?
Can a scotoma resolve on its own?
Which doctor should I see for a scotoma?
Is a scotoma dangerous?
References
- https://cr.minzdrav.gov.ru/ — Clinical Guidelines of the Russian Ministry of Health
- https://minzdrav.gov.ru/ — Russian Ministry of Health
- https://www.rmj.ru/ — Russian Medical Journal
- https://www.mediasphera.ru/journal/vestnik-oftalmologii — Ophthalmology Bulletin
- https://eyepress.ru/ — specialized ophthalmology materials
- https://cyberleninka.ru/ — Russian-language scientific articles on the following topics: scotoma, perimetry, glaucoma, migraine with aura, visual field defect
Our doctors
This award is given to clinics with the highest ratings according to user ratings, a large number of requests from this site, and in the absence of critical violations.
This award is given to clinics with the highest ratings according to user ratings. It means that the place is known, loved, and definitely worth visiting.
The ProDoctors portal collected 500 thousand reviews, compiled a rating of doctors based on them and awarded the best. We are proud that our doctors are among those awarded.
Make an appointment at a convenient time on the nearest date
Price
Other services
Appointment to the doctor
Reviews
Our clinics
Application “Personal Account K+31”
What is a scotoma and how does it differ from a physiological blind spot?
A scotoma is a visual field defect in which a portion of the image is completely or partially lost. The visual field is the entire area a person can see in front of them without shifting their gaze. If a dark spot, a gap, a fog, or an area of reduced brightness appears in this area, the doctor suspects a scotoma.
Everyone has a physiological blind spot. It corresponds to the exit point of the optic nerve, where there are no light-sensitive cells. In normal life, the brain "completes" the image, so the person doesn't notice it.
When a "blind spot" becomes a sign of disease
A pathological scotoma is characterized by its sudden onset, enlargement, recurrence, or interference with vision. If the blind spot is accompanied by flashes of light, pain, headache, blurred vision, or a sudden deterioration in vision, an ophthalmologist should be consulted. Neurological symptoms may also require a neurologist.