Central Scotoma

• overlap with Optic Atrophy

Examination

• visual acuity
  • decreased
• Fields
  • loss of centre of visual field
  • preservation of peripheral fields
• Pupils
  • normal / afferent pupillary defect
• Movements
  • normal
• Fundi
  • depends on cause
    • Optic Atrophy
    • Macular Degeneration

Causes

• primary
  • damage to nerve
    • Demyelination
    • Compression
      • tumour
      • Paget's Disease
      • Thyroid Eye Disease
    • Ischaemic
    • Toxic
      • methyl alcohol
      • lead
      • quinine
    • Infective
      • Syphilis
    • Nutritional
      • Vitamin B12
    • Hereditary
      • Freidrich's Ataxia
      • Leber's optic atrophy
    • Glaucoma
• Secondary
  • chronic Papilloedema
• Consecutive
  • Retinitis pigmentosa
  • Choroiditis