Progressive visual impairment resulting in optic atrophy is not a common finding in patients with pernicious anemia and subacute degeneration of the spinal cord. In 1959, Hamilton, Ellis, and Sheets1 in a comprehensive review of the literature found only 28 well-documented cases of optic neuropathy associated with pernicious anemia and added 1 case of their own. The onset of visual impairment antedated other manifestations of pernicious anemia in 9 of the reported cases, while the ocular involvement was the only significant finding in 3 cases. In view of the relative scarcity of reports on visual field defects as a manifestation of impaired absorption of B12, the following case is presented.
Report of Case
The patient is a 57-year-old white man who was first seen in October, 1959, with the complaint of slow progressive failure of vision over the preceding 6 months. He had been referred by an optometrist
LERMAN S, FELDMAHN AL. Centrocecal Scotomata as the Presenting Sign in Pernicious Anemia. Arch Ophthalmol. 1961;65(3):381-385. doi:10.1001/archopht.1961.01840020383011