We have observed that the majority of patients with bilateral macular disease utilize an eccentric region for viewing or fixation which is above the fovea or macula, its distance from the latter depending on the size of the central scotoma. The consistency of this behavior (exceptions occur but are rare1) can be demonstrated by visuscopy, serial fixation photography,2 or perimetry.3 Aulhorn, who made perimetric examinations of 100 patients with macular disease, did not find a single case in which the central scotoma was below the horizontal; that is, fixation was concerned during perimetry with an area below the macula.3
This tendency of eyes with loss of central vision to utilize a supramacular region gave rise to the question of how normal eyes behave when the fovea is temporarily deprived of its function. While in earlier studies2 a scotoma was produced by dazzling the macula with
von NOORDEN GK. Peripheral Viewing in Scotopic Vision. Arch Ophthalmol. 1963;69(5):547–550. doi:10.1001/archopht.1963.00960040553002
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