Missing areas of vision, or blind patches, occur when part of the visual field is lost. Causes range from retinal damage to neurological disease.
Pathways
Retinal holes, detachments, macular disease, glaucoma, and vascular occlusions produce localised scotomata. Lesions of the optic nerve, chiasm, or brain, such as from stroke or tumours, create characteristic field defects.
- Patients may notice gaps when reading, bumping into objects, or missing parts of images
- Small scotomata can go unnoticed without testing
- Transient missing areas may occur with migraine aura or transient ischemia
- Both eyes together may compensate, masking monocular defects
Investigation
Formal field testing, ocular examination, and neuro‑imaging as needed identify the level of damage. Timely treatment can stabilise or sometimes improve function.
- Sudden onset or progression requires urgent assessment
- Rehabilitation strategies help patients adapt to permanent loss
- Drivers with field defects must follow legal guidance
- Underlying systemic disease should be addressed to prevent further events
