A central scotoma is a blind spot that occurs in the center of one’s vision.  It can appear in several different ways.  It may look like a black or gray spot for some and for others it may be a blurred smudge or a distorted view in one’s straight ahead vision.  Scotomas may start out as a small nuisance and then get larger or there may be several blind spots or scotomas that block one’s field of vision.   Scotomas that develop in the periphery of one’s vision are not as concerning or disabling as those that develop in the center.

Symptoms of Central Scotomas

This interference with what one sees straight ahead versus what one sees to the side greatly impacts the ability to perform daily functions.  The gray, blurred, distorted or black spot blocks out a person’s face, words on a page, labels on a jar, or the petals of a flower.  Seeing and recognizing faces, watching television or movies, and reading the newspaper, books or magazines becomes difficult .

Common Causes of Central Scotomas

When nerves in damaged areas of the retina do not send visual messages to the brain, a person experiences a scotoma or blind spot. The most common causes of central scotomas are disorders of the optic nerve, choroid or retina, such as macular degeneration.  Eye infections that result in a scar or strokes, tumors, and traumatic brain injuries may result in this type of vision loss.

Help for Central Scotomas

First it is necessary to be evaluated by a specialist to determine the cause of your loss of visual field.  Most often you will need to be evaluated by an ophthalmologist who can check the retina and/or optic nerve for involvement.  Once a diagnosis is confirmed, the eye specialist can make recommendations for medical treatment.  However, in spite of treatment central scotomas may not go away.  Learning to adapt to this vision loss will help you maximize the vision you do have.  Some tips to help one “see around” the scotoma  include using more and better lights, utilizing contrast to enhance light against dark or dark against light, and magnifying your reading with magnifiers, ebook readers or magnifying software.  Switch to talking devices such as voice activated smart phones, books on tape, text to speech software, or talking watches.

Find and use your preferred retinal locus.  A person looks slightly to the side so that the blind spot or scotoma is not in their central field of vision. One author describes it as “not looking at what you want to see.”  To learn more about how to maximize your usable peripheral vision watch this instructional video:

Eccentric Viewing – How it’s Done and Where to Get Training

Leslie Degner, RN, BSN

www.WebRN-MacularDegeneration.com