Understanding Scotomas: Types and Causes

Example of a scintillating scotoma, as may be caused by cortical spreading depression
Example of a scintillating scotoma, as may be caused by cortical spreading depression


Scotomas are visual field abnormalities characterized by areas of reduced or lost vision. They can arise from various underlying conditions, affecting different parts of the visual field. In this blog article, we will delve into the different types of scotomas and explore their causes, shedding light on these vision impairments.

1. Arcuate Scotoma

Arcuate scotoma is a type of visual field defect characterized by an arc-shaped area of reduced vision. This type of scotoma is commonly associated with glaucoma, a condition that damages the optic nerve, resulting in peripheral vision loss. Arcuate scotomas often manifest as a partial loss of vision in the outer edges of the visual field.

2. Cecocentral Scotoma

Cecocentral scotoma refers to a blind spot that occurs in the center of the visual field. It typically presents as a dark spot in the middle of one’s vision. This type of scotoma is frequently associated with conditions such as macular degeneration and retinitis pigmentosa, where the central part of the retina is affected.

3. Ring Scotoma

Ring scotoma appears as a circular area of reduced vision with a central area of preserved vision, creating a “ring-like” pattern. This scotoma can be linked to conditions like migraine with aura or other neurological disorders that affect the visual pathways.

4. Scotoma vs. Floater

It is essential to differentiate between scotomas and floaters. Floaters are small specks or spots that seem to “float” in one’s vision and are caused by changes in the vitreous gel inside the eye. On the other hand, scotomas are more significant areas of vision loss caused by various eye or neurological conditions.

5. Paracentral Scotoma

Paracentral scotoma is a type of visual field defect that affects the central vision, but slightly off-center. It is often associated with conditions like macular degeneration, glaucoma, or optic nerve damage.

6. Central Scotoma Causes

Central scotoma refers to the loss of vision directly in the center of the visual field. This type of scotoma can be caused by conditions such as age-related macular degeneration (AMD), diabetic retinopathy, or optic nerve disorders.

7. Scintillating Scotoma

A scintillating scotoma is a specific type of visual disturbance characterized by a shimmering, zig-zagging, or flashing arc of lights that moves across the field of vision. It usually starts as a small spot near the center of the visual field and gradually expands outward in a crescent or C-shaped pattern. The scintillating scotoma can last for 10 to 30 minutes and may be accompanied by other symptoms such as blind spots, blurry vision, or headache.

Scintillating scotomas are often associated with a visual aura, which is a neurological phenomenon that can occur before a migraine headache. These visual disturbances are caused by changes in the activity of nerve cells in the visual cortex of the brain.

It is important to note that scintillating scotomas and visual auras can also be associated with other conditions, such as certain types of seizures or ocular migraines. If you experience scintillating scotomas or any unusual visual disturbances, it is essential to seek medical attention for proper evaluation and diagnosis.

As with other scotomas, prompt identification and management of scintillating scotomas can help in the early detection and treatment of underlying conditions, leading to better overall visual health and well-being. If you experience recurrent or severe scintillating scotomas, consulting with a healthcare professional, preferably an eye care specialist or a neurologist, is highly recommended to determine the appropriate course of action.


Scotomas can significantly impact one’s quality of life, affecting their ability to perform daily tasks and navigate the world around them. Recognizing the different types of scotomas and understanding their underlying causes is crucial for early detection and timely intervention. If you experience any changes in your vision or notice any unusual visual disturbances, it is essential to seek evaluation and guidance from an eye care professional. Regular eye exams and monitoring can aid in the early detection and management of scotomas, promoting better visual health and well-being.

For additional information, we recommend consulting reputable sources such as the National Institutes of Health (NIH), National Eye Institute (NEI), American Academy of Ophthalmology, American Optometric Association, medical journals, or eye care professionals who specialize in the field of ophthalmology and optometry. These sources can provide reliable and up-to-date information on scotomas and related eye conditions.