- The individual does not realize that they have a blind or black spot
- Most common when the scotoma is due to optic nerve defects
- Similar to negative auras: not seeing something that is there

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- Positive Scotoma
- Negative Scotoma
- Central Scotoma
- Scintillating Scotoma
- Paracentral Scotoma

Types of Scotoma

George T. Banyas, O. D. (2015, September 15). Visual aura and Scotomas: What do they indicate? Review of Optometry. Retrieved February 5, 2022, from https://www.reviewofoptometry.com/article/visual-aura--and-scotomas-what-do-they-indicate 

Visual Aura and Scotomas: What Do They Indicate?

Negative Scotoma

- The patient realizes that they have a blind spot in their vision
- Similar to positive auras: seeing something that is not there


Positive Scotoma

- Condition in which the blind spot is located in direct sight
- Results in difficultly in focusing and seeing color
- However, in low-light conditions, vision becomes slightly better (likely due to the rod photoreceptors being more active than the cone receptors which are located in the fovea, which is the center of the retina)
- Causes include macular degeneration, optic atrophy, optic neuropathy, and glaucoma

Central Scotoma

- Most similar to an aura
- Defect in which an individual has a blurry spot in their vision
- Characterized by a luminous appearance in front of the eyes
- No actual blind spot
- Causes include metastatic cancers and certain medications
 (particularly heart medications)

Scintillating Scotomas

- Visual impairment characterized by the total or relative loss of vision within 10 degrees of center of vision
- Think of this as someone seeing clearly in their line of focus(for example the words on a sign) but not being able to see what is outside of the focus (for example what is next to or near the sign)
- Sometimes can result in tunnel vision if paired with peripheral vision impairments
- An individual can have one or several paracentral scotomas
- Causes include glaucoma (damage to optic nerve) and diabetic retinopathy


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