A series of 52 patients with scotomas attributed to tobacco smoking, alcohol consumption, and nutritional deficits--alone and in combination--was reviewed. Whether use of tobacco alone can produce a scotoma has been a controversial point; our series suggests that it can. Central and cecocentral scotomas did occur in association with smoking alone; there seems to be an association between cecocentral scotoma and cigar smoking especially. Central scotomas were seen more often in patients who consumed alcohol. Recovery from either type of scotoma was observed in 3 months when a therapeutic program of abstinence and B vitamins was followed. Although the number of patients we see with these scotomas has decreased, clinicians are urged to be aware of this disorder.
