Objective In this study we used a scanning laser ophthalmoscope (SLO) to evaluate the oculomotor response to ophthalmic prisms in patients with bilateral central scotomas. Methods Six low vision patients with bilateral central scotomas and six normally sighted subjects were recruited. Nidek MP-1 microperimetry was performed to confirm an absolute central scotoma and identify the subject′s preferred retinal locus (PRL). A Rodenstock SLO captured real time images of the retina while projecting a target onto the previously identified PRL. A 6-8 prism diopter lens was then introduced while the subject was instructed to maintain fixation on the target. Retinal landmarks were used to measure the retinal image shift and subsequent refixation with the PRL. Average deviation and time (timestamp video) to refixate were calculated using ImageJ software. Results Refixation to the displaced target for the study group was within 3 pixels or 11.66 arc minutes (x axis: 2.90±3.92; y axis: 2.53±4.18). The control group refixated more accurately (x axis: 0.33±1.15; y axis: 0.89±2.50), but the amount was not statistically different from the AMD group (tx=1.32, Px>0.05 and ty=0.80, Py>0.05). Time to refixate demonstrated that the control group (0.98±0.19 s) was quicker than the AMD group (2.83±1.63 s) and the difference was statistically significant (t=5.03, P<0.01). One subject did not refixate. His data was excluded and analyzed individually. Conclusion With prismatic image relocation, patients with bilateral central scotomas refixate similar to normal subjects. However, time to refixate was significantly slower in the AMD group and one of the six subjects did not refixate. This data suggests patients with bilateral central scotomas are utilizing the same retinal location with and without the prism in place. Therefore, no benefit is achieved by image relocation.