Blurred vision
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief:
Overview
Blurred vision is a common ocular symptom which is define as a sudden or gradual loss of clarity or sharpness of vision and difficulty to see fine details.It can present unilateral or bilateral.
Pathophysiology
Blurred vision may result from refractive errors, opacity of structures (lens, cornea, vitreous), retina disorder or optic nerve disease.
Causes
Blurred vision is caused by a wide range of eye conditions which include:
- Refractive errors (most common)
- Age-related macular degeneration
- Cataracts
- Presbyopia
- Diabetes retinopathy
- Glaucoma
- Corneal abrasion or scarring; keratitis
- conjunctivitis
- Uveitis
- Iritis
- Retinal detachment
- Retinitis
- Eye trauma (Hyphema)
- Migraine
- Malignancy and tumor (Brain tumor, Lung cancer metastasis, Leukemia)
- Optic neuritis
- Cerebrovascular disease (TIA, stroke)
- Vasculitis (Temporal arteritis,SLE)
- High blood pressure
- Medication
Epidemiology
Depends on the cause, patients of different age groups may develop blurred vision.
Risk Factors
Genetic, Family history, Diabetes mellitus, Age, Hyperlipidemia, Hypertension
Screening
- Screening for Diabetic retinopathy
- Screening for Glaucoma
Natural History, Complications, and Prognosis
The prognosis of blurred vision depends on the underlying cause.
Diagnosis
The diagnosis of blurred vision is based on taking detailed medical history and eye examination.
There are no established criteria for the diagnosis of blurred visin.
History and Symptoms
Patient Should be asked about the onset, duration,associated symptoms and whether blurred vision is bilateral or unilateral. Symptoms which can accompany blurred vision are: Redness of the eye, Eye pain, Epiphoria, Headache, Photophobia, Halos, Nausea, Polydipsia and polyuria, Dizziness, Numbness.
Physical Examination
Eye examination of patients with blurred vision includes :
- [[Visual acuity test
- Visual fields examination
- Slit lamp
- Ophtalmoscopy
- Tonometry
Laboratory Findings
Patients with systemic disorders should have appropriate testing: An elevated concentration of blood sugar and HgA1C is seen in blurred vision due to diabetes mellitus. Urinalysis and renal function testing should be considered in patients with high blood pressure. Antinuclear antibodies and elevated ESR are associated with SLE and vasculitis. CBC with differential count and other tests are needed in some cases( Leukemia, Multiple myeleoma)
CT scan
CT scan of brain may be helpful in diagnosis of mass occupying lesions or Ischemic and hemorrhagic stroke.
Other Diagnostic Studies
There are no other diagnostic studies associated with [disease name].
Treatment
Depends upon the cause, underlying disorders should be addressed.
- Corrective lenses and eyeglasses may correct visual acuity in refractive errors.
Medical Therapy
- Direct injections or intravitreal anti-inflammatory and antiangiogenesis agents(anti-VEGF drugs ) are widely used pharmacotherapy to effectively treat DR and diabetic macular edema (DME).PMCID: PMC5822768
- Glaucoma is usually controlled with eyedrop medicine
- Antibacterial, antiviral and anti parasite agents are the main treatment in infectious causes.
- Corticosteroids are used in the treatment of some kinds of uveitis, iritis and optic neuritis.
- Laser treatment is an option in treatment of diabetic retinopathy.
Surgery
- Surgical intervention like LASIK is commonly used to correct a refractive error.
- Surgery is the mainstay of treatment for cataract.
- Vitrectomy is used in treatment of Diabetic retinopathy
- Different types of surgeries to treat glaucoma are: Trabeculoplasty ,Iridotomy and Trabeculectomy
Primary Prevention
Keeping the glucose level close to the normal level in diabetic patients is the best way to lower the risk of diabetic retinopathy.
Secondary Prevention
There are no established measures for the secondary prevention of [disease name].
References