When patients complain of blurred vision, it is first necessary to define exactly what they mean. It is also important to find the time frame and the extent to which the visual fields are affected. Patients can be very inexact in their terminology so blurred vision must be differentiated from gradual loss of vision and visual field defects. Cranial nerve lesions cause diplopia rather than blurred vision which is important what doctor must remember.
What is blurred vision?
There are many types of eye problems and visual disturbances that include blurred vision, halos, blind spots, floaters, and other symptoms. Blurred vision is the loss of sharpness of vision and the inability to see small details and blind spots called scotomas, which are dark holes in the visual field in which nothing can be seen. You must know that changes in vision, blurriness, blind spots, halos around lights, or dimness of vision should always be evaluated by a medical professional. Such changes may represent an eye disease, aging, eye injury, or a condition like diabetes that affects many organs in the body. Whatever the cause is, vision changes should never be ignored because they can get worse and significantly impact the quality of life, so professional help is always necessary.
As you determine which professional to see, you should know that opticians dispense glasses and do not diagnose eye problems. Optometrists perform eye exams and may diagnose eye problems, so they prescribe glasses and contact lenses while in some states they prescribe eye drops to treat diseases. Ophthalmologists are physicians who diagnose and treat diseases that affect the eyes, so these doctors may also provide routine vision care services, such as prescribing glasses and contact lenses. Sometimes an eye problem is part of a general health problem, when your primary care provider should also be involved.
Common causes of blurred vision
Cataracts are also a common cause, and this is cloudiness over the eye%26rsquo;s lens causing poor nighttime vision, halos around lights, and sensitivity to glare, until even daytime vision is eventually affected. This condition is also common in the elderly.
Glaucoma is the next cause of blurred vision, which is increased eye pressure, causing poor night vision, blind spots, and loss of vision to either side. Glaucoma is a major cause of blindness. It can happen gradually or suddenly but if it is sudden, it is a medical emergency.
Diabetic retinopathy is complication of diabetes that can lead to bleeding into the retina, and is another common cause of blindness.
Macular degeneration is loss of central vision, blurred vision, especially while reading, distorted vision, like seeing wavy lines, and colors appearing faded. This is the most common cause of blindness in people over age 60.
Further causes of blurred vision can be eye infections, inflammation, or injury. Floaters are tiny particles drifting across the eye and although often brief and harmless, they may be a sign of retinal detachment. Retinal detachment with symptoms that include floaters, flashes of light across your visual field, or a sensation of a shade or curtain hanging on one side of your visual field could also cause blurred vision. Optic neuritis is inflammation of the optic nerve from infection or multiple sclerosis, so you may experience pain when moving your eye or touching it through the eyelid.
Stroke or TIA, brain tumor and bleeding into the eye, are also causes of blurred vision.
Temporal arteritis is an important condition, an inflammation of an artery in the brain that supplies blood to the optic nerve. Migraine headaches occur as spots of light, halos, or zigzag patterns. These are common symptoms prior to the start of the headache. An ophthalmic migraine is when you have only visual symptoms without a headache at all.
Other potential causes of vision problems include fatigue, overexposure to the outdoors, temporary and reversible blurring of vision, and many medications. Medications that can affect vision include antihistamines, anticholinergics, digitalis derivatives, some high blood pressure pills, indomethacin, phenothiazines, medications for malaria, ethambutol, and many others.
Safety measures may be necessary if you have any vision problems, for example if you have trouble seeing at night, you should not drive after dusk. It may be helpful to increase the amount of light in a room or arrange a home to remove hazards, and specialist at a low-vision clinic may be able to help. If you experience partial or complete blindness in one or both eyes, even if it is only temporary you should immediately call your doctor. It is also important to call him if you experience double vision, even if it is temporary and if you have a sensation of a shade being pulled over your eyes or a curtain being drawn from the side. Blind spots, halos around lights, or areas of distorted vision appear suddenly are warning signs as well. If you have eye pain, especially if also red call the doctor, because a painful eye is a medical emergency. If you have trouble seeing objects to either side, difficulty seeing at night or when reading, gradual loss of the sharpness of your vision, difficulty distinguishing colors, blurred vision when trying to view objects near or far, or diabetes (or a family history of diabetes) you should definitely talk to your doctor. Your provider will check your vision, eye movements, pupils, the back of your eye and eye pressure when needed. An overall medical evaluation will be performed if necessary, but you should not be worried about it, just report your problem to a professional.
What should the doctor ask you?
For diagnosis it is extremely important to know if there is blood (hyphema) or pus (hypopyon) in the anterior chamber. In some cases doctor will suspect the cause of blurred vision is a cataract. To get exact diagnosis it is helpful to check the blood pressure and check urine for glucose, examine the pulse for atrial fibrillation, and listen for any carotid bruit.
If the fovea or macula is affected there will be a dramatic loss of vision. Investigation will depend upon what is suspected; it may require urgent (on the same day) referral to an ophthalmologist for slit lamp examination and a definitive diagnosis. Differential diagnosis means it is helpful to divide into unilateral and bilateral, including homonymous, sudden and gradual in onset, and painful and painless. In addition, glaucoma may affect both eyes but usually only one at a time has an acute attack. Giant cell arteritis may affect one eye initially and immediate starting of steroids is essential to protect the other eye, and chemicals or foreign bodies in the eye may be unilateral or bilateral. Unilateral, sudden and painful are often associated with a painful red eye, which could be corneal abrasion or infection, anterior uveitis, traumatic hyphema, or acute glaucoma. There may even be prostration and vomiting as well. Giant cell or temporal arteritis may be associated with a painful or tender head but the eye is not usually painful and there is usually a complete unilateral loss of vision rather than a complaint of blurred vision. Some people get a typical migraine prodrome without a following headache and it is usually unilateral but may progress to be homonymous. Blurred vision can be part of a toxic illness, which is apparent the patient that is pyrexial and unwell. There will probably be a history of welding a number of hours earlier with inadequate protection and often the patient will offer the diagnosis on its own. It is interesting that drugs like steroids and anticholinergics can also have similar effects. Cerebrovascular disease may lead to damage to the visual pathways and optic cortex. Because of that, there may or may not be macular sparing associated with visual disturbance that is often homonymous.
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