Funduscopically controlled scotometry
Abstract
The following is a brief summary of the results in our ten groups of cases. The positive features of laser scotometry are emphasized. The normal response is well defined: there are no uncertain blind spot margins. The peripheral field is probably extended beyond 60 degrees nasally and superiorly. The size and shape of the small central scotomas associated with macular holes are easily defined and correlated directly with the visible edge of the hole. This result is distinct from the intact subjective response with cystoid maculopathy and surface wrinkling retinopathy. Plotting the margins of peripheral abnormalities such as retinal detachments, retinoschisis, and lattice degeneration is easily done. Schisis is distinguished by an absolute scotoma. This scotometry is facilitated by a larger "normal" field with the laser instrument. Lattice degeneration causes a field defect. A branch retinal artery occlusion shows a slightly jagged border, difficult to detect by standard methods. A cotton-wool spot does not show a total nerve-fiber-bundle defect. Small absolute scotomas are correlated with degenerative changes within nevi. Degenerative changes over small melanomas--ie, the orange spots--also produce absolute field defects. "Bear track" lesions have a normal field, whereas dense black isolated lesions are associated with absolute scotomas. In macular degeneration the bright laser test object is usually visible to the patient within detachments of neuroepithelium, detachments…
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