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Article
September 1940

CENTRAL SCOTOMAS: THEIR IMPORTANCE IN TOPICAL DIAGNOSIS

Author Affiliations

BALTIMORE
From the Wilmer Ophthalmological Institute and the Department of Neurology of the Johns Hopkins Hospital and University.

Arch Ophthalmol. 1940;24(3):500-534. doi:10.1001/archopht.1940.00870030076010
Abstract

This paper has been written in an effort to indicate the significance of central scotomas, particularly from the standpoint of topical diagnosis. The study is principally based on clinical cases illustrating the occurrence of central defects in visual fields occasioned by lesions at various levels in the optic pathways.

ANATOMY  While no effort is made to describe the minute anatomic structure of the macula and the papillomacular bundle, attention is drawn to certain anatomic arrangements which account for definite characteristics in cases of central field defects.Macula.—With the red-free light the macular fibers are seen to follow an arching course above and below the fovea centralis, which they do not cross, to reach the temporal side of the optic nerve, where they form the papillomacular bundle. Localized lesions in the macular region which are readily visible on ophthalmoscopic examination, and with which for the most part we are not

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