| Sumario: | Background: Having a preferred retinal locus or loci refers to the utilization of one or more eccentric retinal fixation points, most often occurring with loss of foveal function. This article proposes the theory that surgical pupil displacement could facilitate development of an optimally functioning preferred retinal locus in those with macular degeneration/ absolute central scotoma while enhancing the potential for reorganization of visual processing. Case Report: A seventy-five year old aphakic male presented complaining of blurred vision with his habitual aspheric spectacles. He reported having had extracapsular cataract extraction for congenital cataracts OD, then OS, at seventeen years of age. He had mild corectopia OD, a severely updrawn peaked pupil OS, and best visual acuity (BVA) limited to 20/40-1 OD and 20/40 OS at distance. Scanning laser ophthalmoscopy indicated the use of a preferred retinal locus OU. With chronic dilation of the patient’s updrawn pupil OS, the visual axis was enabled, the dimensions of the visual field OS were significantly increased, and BVA improved to near normal OS. Conclusion: A patient with macular degeneration/absolute central scotoma who has a centered pupil and normal peripheral retina in the absence of other significant ocular or neurologic pathology could, in theory, benefit from surgically induced corectopia. This would enable direct light stimulation of a preferred retinal site, an area of viable retina determined to be the most appropriate for establishing a single, stable, preferred retinal locus when there has been loss of foveal function. This could enhance the potential for reorganization of visual processing.
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