| Sumario: | Background: Patients with central scotoma report difficulty with reading and many other activities of daily living. While some patients easily adopt an eccentric viewing posture, the majority of patients need to be taught both that the scotoma exists and the most effective way to view around it. Patients with strabismus and amblyopia who eccentrically fixate are taught to view with the macula through vision therapy. Patients with central scotoma can use many of these same techniques to learn to view with an eccentric point, to develop efficient eye movements, and to develop eye-hand coordination using this new eccentric location. Case Reports: Two cases are presented of patients with functional difficulties related to central scotoma. The first case involves a 66-year-old female with dry age-related macular degeneration. The second case is a 38-year-old female with Stargardt's disease. Discussion: Limitations of the peripheral vision system in terms of resolution, reduced visual span, oculomotor deficits, and slower processing all contribute to difficulties with reading and slower reading speed in patients with central scotoma. Vision therapy for oculomotor skills resulted in both patients having a modest increase in reading speed, which is consistent with the current literature. Eye care providers should consider adding optometric vision therapy techniques to other methods in place in order to help patients with central scotoma maximize their visual function.
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