Various aspects of the syndrome known as "tobacco-alcohol amblyopia," "alcohol amblyopia," "tobacco amblyopia," and, more recently, "nutritional amblyopia," have been examined in several previous communications.1-3 In spite of evidence to the contrary, some observers still contend that patients with this condition should be divided into two distinct groups: (1) those with chronic alcoholism, and (2) those who smoke pipes or cigars but drink only moderately or not at all. All now seem to agree, however, that patients suffering from chronic alcoholism, or from malnutrition from some other cause, may develop nutritional amblyopia. Those who favor using the term "tobacco amblyopia" for the disease of the tobaccosmoking, nondrinking group state that the scotoma of this condition differs from the scotoma of "nutritional amblyopia." As long ago as 1878, Hirschberg4 claimed that he could differentiate tobacco amblyopia from alcohol amblyopia by the type of scotoma. Uhthoff, Groenouw, and others5