Junctional scotoma
The patient has a right central scotoma and superior temporal field defect in the left eye. The findings suggest a lesion in the junction between the optic nerve and the chiasm on the side with the central scotoma. What is the anatomical explanation for junctional scotoma?

Other examination:

  • Mention you would like to examine the fundi for optic atrophy on the side with central scotoma and possible papilloedema on the other side.
  • Look for cases. The most common causes are meningioma and a prefixed pituitary tumour. In the former, the patient may have proptosis and in the later signs of hypopituitarism or acromegaly.