Question:hard
Following perimetry image is suggestive of? 
Following perimetry image is suggestive of?
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A curved comma-shaped field defect arching from the blind spot around fixation is the classic glaucomatous arcuate scotoma.
Updated On: Jun 22, 2026
- Extension of blind spot
- Arcuate scotoma
- Reinee step defect
- Altitude Anopia
Show Solution
The Correct Option is B
Solution and Explanation
Read the shape of the field loss. The trick to a perimetry question is to match the geometry of the dark (lost) area to a named defect. Here the printout shows a curved, comma- or arc-shaped band of depressed sensitivity sweeping from the region of the blind spot around the central fixation point.
This curved shape is dictated by retinal anatomy: ganglion-cell axons sweep in an arcuate path (the Bjerrum arcuate bundles) around the macula on their way to the optic disc. When these bundles are damaged - the hallmark of glaucoma - the resulting field loss copies their curved course, giving an arcuate scotoma. It is the textbook early glaucomatous visual-field defect.
Contrast with the distractors:
• Enlarged blind spot is a focal patch hugging the blind spot (papilloedema), not a long arc.
• Roenne's (Reinee) nasal step is specifically a horizontal "step" mismatch in the nasal field, a more advanced glaucoma sign, not the broad curve here.
• Altitudinal field loss wipes out a whole upper or lower half along the horizontal line (ischaemic optic neuropathy), which is not the curved pattern depicted.
So the perimetry is suggestive of an Arcuate scotoma (Option B). (The paper did not print an answer key for this question, so this is the best-supported derived answer from the glaucomatous arcuate pattern.)
This curved shape is dictated by retinal anatomy: ganglion-cell axons sweep in an arcuate path (the Bjerrum arcuate bundles) around the macula on their way to the optic disc. When these bundles are damaged - the hallmark of glaucoma - the resulting field loss copies their curved course, giving an arcuate scotoma. It is the textbook early glaucomatous visual-field defect.
Contrast with the distractors:
• Enlarged blind spot is a focal patch hugging the blind spot (papilloedema), not a long arc.
• Roenne's (Reinee) nasal step is specifically a horizontal "step" mismatch in the nasal field, a more advanced glaucoma sign, not the broad curve here.
• Altitudinal field loss wipes out a whole upper or lower half along the horizontal line (ischaemic optic neuropathy), which is not the curved pattern depicted.
So the perimetry is suggestive of an Arcuate scotoma (Option B). (The paper did not print an answer key for this question, so this is the best-supported derived answer from the glaucomatous arcuate pattern.)
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