Automated perimetry in a patient with normal tension glaucoma reveals a defect that is denser superiorly, respects the horizontal midline, and has a sharp nasal step. Which perimetric pattern is described?
- A Altitudinal field defect
- B Temporal wedge defect
- C Arcuate (Bjerrum) scotoma with nasal step ✓
- D Central scotoma
Correct answer: C. Arcuate (Bjerrum) scotoma with nasal step
Explanation
An arcuate (Bjerrum) scotoma arises from damage to the arcuate nerve fibre bundle at the optic disc and produces a curved defect that sweeps from the blind spot around fixation, respecting the horizontal meridian. When the superior and inferior arcuate defects differ in density, a nasal step results at the horizontal midline. This pattern is characteristic of glaucoma and normal tension glaucoma.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.