The scotomas are blind spots in the field of vision. They may be temporary or permanent and, in the latter case, may or may not be treated. For this reason, as soon as you have a blind spot in your eye, if you have not already been diagnosed by an ophthalmologist, you need to see one as a matter of urgency.
Depending on where these areas of blindness appear, we will need specific or additional tests. Early treatment when a permanent scotoma appears can delay partial blindness for years. At Nebro Ophthalmology Clinic we have all the necessary equipment for the diagnosis and monitoring of patients with this visual field impairment.
What is a scotoma?
In principle, we call any blind spot in the eye a scotoma. This blind spot can be perceived as a black spot within the visual field, as a blurred area or as a flash that is not occurring and can appear at any time in the same specific point of an eye or can move around, unlike floaters, which do move around.
The most important thing is to know the cause. For example, scotoma is a common symptom in many migraine attacks, in which case it resolves on its own as the episode passes. But a central scotoma, which does not move over the course of minutes or hours, is usually a symptom of a build-up of fluid in the area of the macula, where it causes swelling that affects central vision and is cause for immediate consultation with an ophthalmologist.
Permanent scotomas, i.e. those that do not resolve on their own in a few hours or days (sometimes, due to trauma, these blind spots may appear while an inflammatory process is resolving), are an alarming symptom.
What could be the causes?
We have outlined some of the causes of scotomas, but let's look at them all.
- In transient scotomas, the most common cause is a migraine, although it could also be due to a very specific trauma.
- Permanent scotomas can be caused by a stroke or a tumour affecting the optic nerve or the brain, as well as damage to the structures leading from the eye to the image-processing area of the brain (brain scotoma symptoms). glaucoma(e.g. multiple sclerosis, multiple sclerosis or intracranial hypertension).
- Some scotomas are a warning sign of cataract formation, and usually affect both eyes. They usually begin with blurred regions, which can lead to no visibility at all.
- Cases of central scotomas warn of problems in the retina, ranging from retinal detachment to DMAE. It may also warn of the presence of a lesion or scar tissue in the retina. It is not uncommon for both eyes to be affected.
- High cholesterol levels can cause scotomas, as can obesity.
- Finally, anyone with diabetes or hypertension should pay special attention to the appearance of this type of visual problems, even if they are transitory. It is better to consult a specialist to rule out something serious or you run the risk of remaining partially blind.
Symptoms of scotomas and how to diagnose them
Symptoms
The symptoms are clear. It usually appears in one eye only, with one or more blurred spots, black spots or flickering. At the same time, there is almost always greater or lesser difficulty in focusing correctly on objects, similar to eyestrain but without a clear cause.
Sometimes regions of partial blindness are located at the periphery of the visual field, resulting in tunnel or shotgun vision. This type of scotoma can be permanent or transient. When it is temporary, it may be due to a migraine or panic attack.
Depending on the extent and location of the blind spots, the patient may have problems walking without stumbling or handling objects such as cutlery on the table or a pen when reaching for them.
Diagnosis
With such a wide range of causes, the diagnosis is made by studying the patient's clinical history and an initial eye examination to see what further diagnostic tests are necessary.
After checking the visual acuity and looking at the back of the eye, we usually perform a campimetryto obtain precise information on the size and location of the scotoma(s).
Your ophthalmologist may also order other tests, such as an MRI or lumbar puncture, to confirm or rule out neurological lesions and intracranial hypertension, respectively. In these cases, an accurate diagnosis becomes the result of the work between ophthalmologists and neurologists.
Treatment of scatoma
The treatment of a scotoma depends on the cause of the scotoma. When they are transient and caused by migraines, they resolve on their own in less than an hour, although we may recommend medication to space out migraine attacks with aura or reduce their intensity.
If the cause can be eliminated, as in the case of hypercholesterolemia, it is treated by the appropriate specialist and we follow up on what affects only the health of the eye and the optic nerve.
In chronic diseases, disease control is the treatment strategy to prevent small scotomas from increasing in extent.
Whenever a patient is faced with a permanent scotoma, we can provide specific therapy to help them learn to cope with these visual field impairments, to improve their quality of life and to reduce the risk of dependency.
This therapy includes exercises combined with changes in reading habits or the use of digital devices: larger print, filters to avoid glare or, when partial blindness is significant, the use of programmes that convert text to speech and vice versa.
The results of this therapy depend on the extent of the blind spots and where they are located.
As we have seen, the scotomas are blind spots or patches in the field of vision. They may be transient or permanent, and the latter may remain stable or, more commonly, increase if left unchecked. The causes are so varied that it is not possible to establish a single protocol for diagnosis. For this reason, the ophthalmologist will need to know your clinical history and, if the diagnostic tests do not give conclusive results, work as a team with neurologists until the cause is found. From then on, we will only deal with matters concerning the ocular structure and the optic nerve, and propose additional therapy to improve the patient's daily life.
Visit Dr. Nebro Clinic for Clear and Complete Vision
If you are experiencing any symptoms related to scotomas or have concerns about your visual health, do not hesitate to consult us. At the Dr. Nebro Cliniclocated in Fuengirola (Malaga), we specialise in comprehensive vision care. We offer accurate diagnoses and personalised treatments to ensure you receive the best possible care.
Don't let blind spots affect your quality of life. Our team of experts is here to help you see the world more clearly. Visit us today and take the first step towards a healthy and fulfilling vision!