Residual vision in a scotoma: implications for blindsight.

Blindsight, the ability of some blind patients to describe attributes of stimuli they have no conscious awareness of seeing, has been attributed to a secondary (retinotectal) visual pathway. However, it has also been proposed that blindsight could be due to residual function within the primary (geniculostriate) visual pathway. Data have now been obtained that support the second alternative. With an image stabilizer ensuring the accurate retinal placement of stimuli, dense visual field mapping was carried out with a hemianopic patient. This perimetry revealed, embedded in the patient's scotoma, an isolated 1-degree island of residual vision that was not disclosed by conventional perimetric methods. Stimuli presented to this island could be detected and discriminated, although the subject reported he did not see them. The existence of this island of vision implies a corresponding island of functioning cortex within the patient's lesion. Other instances of blindsight may be mediated by similar islands of functioning cortex.