Clinical significance of central scotomata of the visual field

Abstract

The object of this Thesis is to demonstrate the value of the examination of the central field of vision as an aid to diagnosis. By picking out one particular sign, i.e. central scotoma, for study, it is not meant that by this sign alone can a diagnosis infallibly be made. It is never possible to make a diagnosis from any one sign or one method of examination. Rather must the entire clinical picture be taken into consideration. This picture is made up of innumerable small portions which, when fitted together like the parts of a jig saw puzzle, present to the examiner's view an entire and recognisable picture. In medical diagnosis, however, each single fact must be subjected to the minutest scrutiny and it is for the scrutiny of the part called "Central Scotoma" that this Thesis has been conceived and compiled.In this summary there will be unavoidably a certain amount of repetition, as a short summary has been appended to the end of most of the divisions in order to clinch the outstanding points while still fresh in the reader's mind.. Again, unavoidably a few important if rare conditions are omitted and others remain unillustrated by original cases, as it has been thought better to give a description of the conditions only than to illustrate with cases taken from the work of other observers.The subject has been divided under several headings:I. CHOROID AND RETINA.II. OPTIC NERVE.III. CHIASMA.IV. SUPRACHIASMAL PATHWAY.