California School for the Blind



What are scotomas?
The retina is like a thin skin on the inside of the eye.  It is in the back of the eye.  It holds the nerves that get light through the pupil.  The nerves send visual messages to the brain.  There may be places on the retina where the nerves do not work.  The light does not make them work.  They do not send visual messages to the brain.  These spots are called scotomas.

What causes scotomas?
Many things can cause scotomas.  They can be caused by surgery that doctors do to fix something else in the eye.  They can come from an infection in the eye that left a scar.  The infection may have happened while the baby was still growing in the mother.  They can be caused by an eye problem called retinitis pigmentosa.

What kind of vision do people have who have scotomas?
People who have scotomas have different vision depending on where the scotoma is.

People who have a central scotoma may have trouble seeing colors and details.  It may be hard for them to know who people are by looking at their faces.  They may have a hard time reading regular size print.  They may look from the side of their eyes, and people may not know what they are looking at.  They may see best in dim lighting.  They may notice things best when they are moving.

People who have peripheral scotomas may see fine when looking at details and colors.  They may see best in well-lit areas.  They may bump into things when they are walking because they did not see them.

What will help you if you have scotomas?
1.  An eye doctor can help you find out where the scotomas are.  Then you will know if they are central or peripheral.
2.  If you have central scotomas, it may help to make things bigger.  The easiest way to make things bigger is to get close to them.  Use a bookstand to hold your book so that you can sit up to look at it up close.  Maybe a magnifier will help you see things close to you.  You can make print and pictures bigger on the computer or with a copy machine. 
3.  It may help to make things smaller.  If your central scotoma only covers part of your center vision, you may like to have things that are small to look at so that you can see them around the scotoma.  If you want to have a wider view of things, you can use a monocular telescope to do that. Hold the telescope backwards.  Things will look small, but more will fit into the view.  It is best to use a telescope that is made to make things look two to four times bigger for this.
4.  If your scotoma covers a lot of the central vision, you may want to learn braille and to use listening for learning.
5.  If you have central scotomas, it may help to move print when you try to read it.  Some computer software will move print across the screen for you.
6.  You may want to dim the lights.  In dim light your pupil will open wider.  There will be more room for vision information to get into your eyes.  You may see better if you wear a cap with a brim and sunglasses in brightly lit places.
7.  If you have peripheral scotomas, you may want to learn to use a white cane to avoid bumping into things.  The cane can warn you if there are cracks in the sidewalk or other things that you could trip on.


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