Persons with scotomas in their central 20° of vision often do not notice these blind spots within their visual field and have visual performance difficulties far exceeding what would be expected from standard vision tests. Before persons with macular scotomas can be assisted to optimally use their remaining vision for a better quality of life, more must be known about how the visual system adapts to a macular scotoma. Important issues include spatial and temporal characteristics of perceptual completion and metamorphopsia, development of preferred retinal loci for fixation and visual search, and dynamics of the preferred retinal locus development in terms of the changes in the eye movement system. With a full understanding of the visual system’s adaptation to macular scotomas, new low vision devices and training techniques can be proposed to promote independence in activities of daily living for the person with low vision.

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