What is the cause of peripheral scotoma (a type of visual field defect)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 14, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Peripheral Scotoma Cause

The cause of peripheral scotoma is not directly addressed in the provided evidence, but based on the context of visual field defects discussed, it can be inferred that peripheral scotoma is likely caused by damage to the retina or optic nerve, affecting the peripheral visual field.

  • The evidence primarily focuses on central visual field defects, such as central scotomas, and their impact on vision rehabilitation 1.
  • However, the discussion on visual field defects and scotomas in general suggests that peripheral scotoma may result from similar underlying conditions, such as retinal disease, optic neuropathy, or brain injury 1.
  • The use of microperimetry and other tests to assess central visual field defects may also be applicable to diagnosing peripheral scotoma, although this is not explicitly stated in the evidence 1.
  • It is essential to note that the evidence provided is primarily focused on vision rehabilitation and central visual field defects, and more specific research on peripheral scotoma would be necessary to determine its exact causes.

From the Research

Causes of Peripheral Scotoma

The causes of peripheral scotoma, a type of visual field defect, can be attributed to various factors, including:

  • Damage along the visual pathway, which results in a visual field defect that retinotopically corresponds to the damaged neural tissue 2
  • Loss of neurons at the retinal ganglion cell level and higher, which can lead to scotomas that are usually invisible to patients 3
  • Ocular abnormalities, such as glaucomatous optic neuropathy, which can cause characteristic visual field defects, including isolated scotomas, arcuate scotomas, nasal steps, and generalized depression 4
  • Congenital conditions, such as tilted disc syndrome, which can present with visual field defects mimicking loss seen in neurological diseases 5
  • Lesions behind the chiasm, which can cause homonymous hemianopia, where the same portion of the field is absent in both eyes 6

Types of Visual Field Defects

There are four classic types of visual field defects, including:

  • Altitudinal field defects, which are usually associated with ocular abnormalities
  • Central scotoma, which is characteristic of optic nerve disease or macular disease
  • Bitemporal hemianopia, which signifies optic chiasm disease and is most frequently associated with pituitary tumors
  • Homonymous hemianopia, which is found with lesions behind the chiasm 6

Detection and Diagnosis

Detection and diagnosis of peripheral scotoma can be achieved through various methods, including:

  • High-resolution perimetry, which can map visual fields with supra-threshold light stimuli 2
  • Humphrey Field Analyzer, which can measure sensitivities across the 30-2 test grid 5
  • Blue-on-yellow perimetry and high-pass resolution perimetry, which are promising tools for early detection of glaucoma 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The Invisibility of Scotomas I: The Carving Hypothesis.

Optometry and vision science : official publication of the American Academy of Optometry, 2023

Research

Neutralizing Peripheral Refraction Eliminates Refractive Scotomata in Tilted Disc Syndrome.

Optometry and vision science : official publication of the American Academy of Optometry, 2018

Research

Visual field defects.

American family physician, 1981

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.