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Visual-Field Defects -  BILATERAL CENTRAL SCOTOMAS Lecture 2 of 14  NEXT»

These are bilateral macular defects with decreased visual acuity; scotomas may be central or centrocecal.

1. Bilateral macular lesions, such as cysts or those due to hemorrhage, edema, degeneration, detachment, hole, or infection (see p. 439)
2. Bilateral optic-nerve lesions

 A. Papilledema with macular edema (see p. 593)
 B. Bipituitary adenoma compressing the prechiasmatic segment of the distal optic  nerve
 C. Papillitis (see p. 578)
 D. Retrobulbar neuritis (see p. 578)

3. Diabetes mellitus
4. Familial optic atrophies (see p. 564)
5. Hyperbaric oxygen
6. Migraine-forerunner of visual aurae
*7. Nutritional deficiency, such as thiamine or vitamin B12 deficiency
8. Pernicious anemia
9. Occipital cortex lesions
10. Toxic agents

 A. Aromatic aminocompounds and nitrocompounds-aniline, nitrobenzene,  trinitrotoluene
 B. Carbon disulfide
 C. Drugs, including:
 


 

acetophenazine
acetyldigitoxin
adrenal cortex injection
alcohol
aldosterone
alkavervir
allobarbital
aluminum nicotinate (?)
aminosalicylic acid (?)
amiodarone
amobarbital
amodiaquine
antazoline
aprobarbital
aspirin
barbital
beclomethasone
betamethasone
bromide
bromisovalum
brompheniramine
butabarbital
butalbital
butallylonal
butaperazine
butethal
caramiphen (?)
carbinoxamine
carbon dioxide
carbromal
carisoprodol
carphenazine
chloramphenicol
chloroquine
chlorpheniramine
chlorpromazine
chlorpropamide (?)
chlortetracycline
ciprofloxacin
cisplatin
clemastine
clomiphene
cobalt (?)
contraceptives
cortisone
cyclobarbital
danazol
dapiprazole hydrochloride
deferoxamine
demeclocycline
deslanoside
desoxycorticosterone
dexamethasone
dexbrompheniramine
dexchlorpheniramine
diatrizoate meglumine and sodium
diazoxide
diethazine
diethylcarbamazine
digitalis
digitoxin
digoxin
dimethindene
diphenhydramine
diphenylpyraline
diphtheria and tetanus toxoids absorbed
disulfiram
doxylamine
emetine
epinephrine
ergonovine
ergot
ergotamine
ethambutol
ethchlorvynol
ethopropazine
fludrocortisone
fluorometholone
fluphenazine
fluprednisolone
gitalin
heptabarbital
hexamethonium
hexethal
hexobarbital
hydrocortisone
hydroxychloroquine
ibuprofenindomethacin (?)
influenza virus vaccine
interleukin 2, 3. and 6
iodide and iodine solutions and compounds
iothalamic acid
isoniazid
lanatoside C
lidocaine
lithium carbonate
medrysone
mephobarbital
meprednisone
meprobamate
mesoridazine
methacycline
metharbital
methdilazine
methitural
methohexital
methotrimeprazine
methoxsalen
methyldopa
methylergonovine
methylprednisolone
methysergide
morphine (?)
naproxen
niacinamide (?)
nicotinic acid (?)
nicotinyl alcohol (?)
ofloxacin
opium
oral contraceptives
ouabain
oxygen
oxyphenbutazone
paramethadione
paramethasone
pentobarbital
perazine
pericyazine
perphenazine
phenobarbital
piperacetazine
prednisolone
prednisone
primidone
probarbital
prochlorperazine
promazine
promethazine
propiomazine
quinacrine
quinidine
quinine
radioactive iodides
secobarbital
sodium
sodium salicylate
streptomycin
sulfacetamide
sulfachlorpyridazine
sulfadiazine
sulfadimethoxine
sulfamerazine
sulfameter
sulfamethizole
sulfamethoxazole
sulfamethoxypyridazine
sulfanilamide
sulfaphenazole
sulfisoxazole
talbutal
thiamylal
thiethylperazine
thiopental
thiopropazate
thioproperazine
thioridazine
thyroid (?)
triamcinolone
trichloroethylene
trifluoperazine
triflupromazine
trimeprazine
trimethadione
vinbarbital

D. Ethyl alcohol
E. Halogenated hydrocarbons-methyl chloride, methyl bromide, iodoform, trichloroethylene
F. Metals-lead, thallium (inorganic), arsenic
G. Methyl alcohol
H. Tobacco

Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn. MA: Butterworth-Heinemann, 2001.

Harrington DO, Drake MV. The visual fields: text and atlas of clinical perimetry, 6th ed. St. Louis: CV Mosby. 1990.

Karanjia N, Dacobson DM. Compression of the prechiasmatic optic nerve produces a junctional scotoma. Am J Ophthalmol 1999; 128, 2:256-258.


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