Overlooking: a sign of bilateral central scotomata in children

Four children are reported who always looked above objects of visual interest (overlooking). All had bilateral central scotomata (loss of central visual field). Three had optic nerve disease selectively affecting the papillomacular fibers; the fourth had ocular colobomata affecting the maculae. Overlooking is an important sign of bilateral central scotomata in children: it is an adaptation to loss of central vision.