Distorted Vision (Metamorphopsia): Definition, Types, and Causes

1. Eye Floaters

Eye floaters are defined as small, dark or grey spots and cob-web like strands that float across your vision and can occur as you get older. Eye floaters can develop when strands of the vitreous gel clump together and cast small shadows. While floaters can accompany old age they may also signify that you may have an underlying eye condition, it is important to have your eyes assessed by an optometrist to get a full diagnosis and to rule out any serious issues. According to John Hopkins, floaters tend to be harmless and usually become less noticeable after some time.

2. Blurred Vision

Blurred vision is defined as vision that is not sharp or appears out of focus, making it difficult to clearly see objects or people. Blurry vision is a common symptom that can develop as a result of many eye diseases and problems. Managing or treating blurry vision will likely require addressing the underlying condition first. If you’re experiencing blurry vision increasingly or suddenly, let your optometrist know right away.

3. Blindness or Partial Loss of Vision

Blindness or partial loss of vision can occur from a range of causes such as cataract, glaucoma, age-related macular degeneration and diabetic retinopathy. Blindness or partial loss of vision is a form of distorted vision, which can occur temporarily as a result of several different eye conditions. It is important to seek medical attention promptly if you do experience this symptom to identify the cause and start treatment in a timely manner if necessary.

4. Blind Spots

Blind spots, also known as scotomas are spots in your vision where you can’t see and can occur in either one or both eyes. According to the Cleveland Clinic, blind spots may be caused by areas on the retina where the nerves are not functioning and as a result, don’t transmit signals to your brain. Blind spots may also develop along with disorders that impair the optic nerve or certain regions in the brain.

5. Flashes of Light

Flashes of light are forms of visual disturbances that can ensue as a result of an underlying condition in your brain or eyes. According to the Cleveland Clinic, patients who have flashes of light in their vision (photopsias) may experience flashes more frequently early in the morning and when they are in a dark room. Flashes of light may also occur along with body, eye or head movement. Light flashes may appear in the form of lightning streaks, zigzag lines, flickering lights, or fuzz. The most common cause of eye flashes may likely come from changes to the vitreous gel in the eye, tugging on the retina. A less serious cause for light flashes can be from physical force such as rubbing or a hit to the eyes.

6. Double Vision (Diplopia)

Double vision, scientifically known as diplopia, is an eye condition that causes a person to either see two distinct images or two overlapping images. The two types of double vision (diplopia) are binocular diplopia and monocular diplopia. Binocular diplopia only occurs when both eyes are open and monocular diplopia occurs even when one eye is shut. Double vision can develop when light that enters the eyes fails to hit both of the retinas at the same point and can either be temporary or permanent. Other than distorted vision, diplopia can also lead to symptoms such as headaches, nausea and dizziness.

7. Halos Around Bright Light

Halos around bright lights are characterised as bright circles of light that surround sources of light and can arise as a sign of eye conditions that alter the shape of the cornea causing light that passes through to bend abnormally. These eye conditions may include Fuchs’ dystrophy, cataract, angle-closure glaucoma, keratoconus, photokeratitis, pigment dispersion syndrome or a side-effect from multifocals. Seeing halos around bright light may be more noticeable at night time around street lights or headlights from cars.

8. Wavy Lines

Wavy lines appearing in vision are commonly associated with macular degeneration or a retina problem and can be described as wavy vision, shimmering lines in vision or seeing wavy lines instead of straight lines. This symptom may cause difficulty with seeing or reading clearly, and may be unsettling for individuals. It is important to see an optometrist in a timely manner if you are experiencing this.

1. Astigmatism

Astigmatism is a common eye condition that causes visual problems due to the lens or the cornea of the eye being unusually shaped. This impedes the retina’s ability to focus light properly and can lead to distorted vision such as blurry vision and glare around lights and eye strain. Astigmatism is a common eye condition with 1.4 million people in Australia reported to have a form of astigmatism according to the Australian Institute of Health and Welfare. The two types of astigmatism are corneal astigmatism and lenticular astigmatism. Corneal astigmatism is the form that develops when the cornea is abnormally shaped and lenticular astigmatism is the form that occurs when the lens of the eye is irregularly shaped.

2. Glaucoma

Glaucoma is an eye disease that can occur when the optic nerve is damaged and can result in the loss of peripheral vision. All types of glaucoma can bring on visual distortions such as vision loss, halos around lights and blurry vision among other symptoms such as sudden and severe pain in the eye, headaches, vomiting and light sensitivity. It is important to note that acute-angle glaucoma is a medical emergency and requires urgent care to prevent vision loss. Treating glaucoma may require prescribed eye drops or surgery depending on how severe your condition is.

3. Dry Eyes

Dry eyes are a common eye condition that stem from either a lack of tears produced or when the secreted tears dry too quickly. Dry eyes can induce distorted vision such as blurry vision and other symptoms such as itchiness, light sensitivity, eye pain or irritation and foreign body sensation. Dry eyes can be treated with eye drops to restore moisture in the eyes, which may also help alleviate irritation and itchiness. However, this will depend on the initial cause and severity of the condition.

4. Optic Neuritis

Optic neuritis is a condition that develops due to inflammation of the optic nerve affecting the eyes and vision. Optic neuritis can result in visual distortion symptoms such as dim vision or blurred vision and pain in the eye as well other symptoms such as colours appearing dull or faded and swelling typically in one eye. It is not established what exactly causes optic neuritis according to the American Academy of Ophthalmology, however, it is suspected that it may be caused by the body’s immune system mistakenly attacking the optic nerve. Diagnosing optic neuritis may involve examining the optic nerve, testing peripheral vision, and assessing how well you see colours and your pupil’s response to light. According to the American Academy of Ophthalmology, many patients require the treatment known as corticosteroids, however, some patients may improve without treatment. Nevertheless, it is important to see an optometrist when experiencing any of these symptoms.

5. Macular Edema

Macular edema occurs due to the build-up of fluid in the macula from blood vessels leaking into the macula, which causes swelling and in turn, blurry vision. Many conditions can cause macular edema such as diabetic retinopathy, age-related macular degeneration, uveitis, blocked veins in the retina, eye surgery and certain medicines. Treating macular edema will require identifying the initial cause and treating the condition, which may aid with macular edema symptoms. According to the National Eye Institute, an eye care professional may also recommend injections with anti-VEGF medication, nonsteroidal anti-inflammatory eye drops and laser treatment.

6. Nearsightedness

Nearsightedness medically known as myopia is a refractive error in which objects in the distance may look blurry while objects nearby remain clear. Nearsightedness (myopia) occurs when the shape of the eye causes light to focus in front of the retina rather than on it. Symptoms of nearsightedness can include difficulty seeing in the distance as a form of distorted vision, having the need to squint to improve vision and eye strain. Managing nearsightedness will require an eye test first to assess the condition of your vision, which will then allow the optometrist to prescribe suitable glasses according to your visual needs.

7. Stargardt Disease

Stargardt disease is a rare inherited eye disease that can result in loss of central vision. Stargardt disease can lead to vision distortions such as blurry vision, central blind spot and colour blindness. Other symptoms can also include light sensitivity and difficulty adjusting from light to dark lighting. According to the Centre for Eye Research Australia, Stargardt disease is typically caused by changes in the ABCA4 gene with a slow decline in central vision being a common first sign. This disease usually presents symptoms during childhood or young adulthood, however, this can vary between individuals. Like most genetic diseases, there is currently no cure for Stargardt disease, however, there are certain steps to take that may be helpful. These steps can include maintaining regular eye tests for vision monitoring, mobility training and using low-vision aids.

8. Macular Hole

A macular hole is a rare eye condition that can cause blurry central vision. Macular holes are characterised as a small gap that develops in the macula and are normally caused by changes in the eye as you age. Symptoms of a macular hole may include distorted vision that looks like the bent appearance of normally straight-edged objects such as window or door frames. Symptoms tend to begin slowly and may not be noticeable if your vision in the other eye is unaffected. Symptoms may become more noticeable over time and can affect your ability to read and drive according to the National Eye Institute. Treating or managing a macular hole may require a type of surgery known as a vitrectomy, however, this is only if the macular hole is affecting your vision.

9. Farsightedness

Farsightedness is a common eye condition that is defined as a refractive error in which light that enters the eye is focused behind the retina as opposed to on the retina as normal, leading to issues with near vision. Farsightedness or also known as hyperopia, may bring on distorted vision in the form of blurry vision, eye strain and headaches. Treatment for farsightedness usually involves prescription glasses. An optometrist can diagnose your condition through a comprehensive eye test, which will help provide all the necessary information to correct your vision.

10. Vitreomacular Traction

Vitreomacular traction can occur when the vitreous in the eye tugs on the macula distorting its usual shape. Vitreomacular traction syndrome can cause visual distortions such as blurry vision and the skewed appearance of straight lines. This syndrome can occur as our vitreous changes with age, becoming more watery. As a result the vitreous separates from the retina, which is the process known as posterior vitreous detachment according to the Macular Disease Foundation Australia. Vitreomacular traction can develop when the vitreous doesn’t fully split from the retina causing the remaining vitreous to pull on the macula. Treatment and management of this condition may only involve monitoring if symptoms are not hindering daily life, a vitrectomy or through an injection according to the Macular Disease Foundation Australia.

11. Retinal Artery Occlusion

Retinal artery occlusion can develop due to a blocked blood vessel in the retina, which can lead to loss of vision. Retinal artery occlusion can take place when the blocked blood vessel comes from a blood clot or cholesterol deposits according to John Hopkins Medicine. Symptoms of retinal artery occlusion can include sudden blindness in one eye, sudden blurry vision in one eye, and continuous loss of vision in the span of a few weeks according to John Hopkins Medicine. It is important to seek urgent medical care if you are experiencing these symptoms as there is a high risk of permanent vision loss and a brain stroke according to the American Academy of Ophthalmology. Treating retinal artery occlusion can include breathing in a mixture of carbon dioxide-oxygen helping the arteries to widen, liquid removal from the eye and massaging the eye to move the clot away. It is important to note that these treatments may be recommended, however, they have not been proven to work all the time according to the American Academy of Ophthalmology.

12. Macular Telangiectasia

Macular telangiectasia is a disease that affects the macula, causing loss of central vision. Macular telangiectasia can develop when there are issues with the small blood vessels around the fovea. The fovea is located in the centre of the macula and is what enables sharp central vision. Symptoms in the early stages of macular telangiectasia can include distorted vision, blurry vision and central vision loss according to the American Academy of Ophthalmology. Type 1 macular telangiectasia causes macular edema as a result of dilated blood vessels around the fovea and harms the cells in the macula. Type 2 occurs when tiny blood vessels surrounding the fovea grow abnormally and dilate. Treatments for this condition have not proven to be effective over the years. However, anti-VEGF injections may help reduce the growth of abnormal blood vessels under the retina.

13. Eye Trauma

Eye trauma can occur from eye injuries, which can include cuts or scratches, foreign objects or chemicals entering the eye or physical forces hitting the eye. Eye trauma can often lead to distorted vision forms such as floaters, light flashes and blurry vision, swelling, pain, redness, watery eyes and bruising. Eye trauma can typically be treated with a cold compress, flushing the eyes and eye drops, however, professional assistance from an optometrist should be sought to ensure there are no further complications and to receive the treatment most suitable to your condition.

14. Keratoconus

Keratoconus is characterised as an eye disease in which the centre of the cornea thins and becomes cone-shaped. The cornea is the clear layer at the front of the eye that helps people see by bending and focusing light as it passes through the eye. The cornea is normally rounded and dome-shaped, but when a person has keratoconus, the cornea turns into a cone-shape which can affect how light enters the eye, leading to vision issues. Symptoms of keratoconus can include blurry vision, double vision, sensitivity to light and the appearance of halos around lights. Treating keratoconus is dependent upon how severe the condition is but may include glasses, contact lenses, corneal cross-linking and a corneal transplant.

15. Central Serous Chorioretinopathy

Central serous chorioretinopathy can develop when fluid leaking from the choroid accumulates under the retina. Central serous chorioretinopathy can cause symptoms such as distorted, blurred and dimmed central vision, dark spots in central vision, bent appearance of straight lines and objects appearing smaller or larger than they should be. Treatment may involve laser treatment, photodynamic therapy, or oral medications. These treatments can seal the leak and restore vision. According to the American Academy of Ophthalmology, most cases may not require treatment and typically alleviate on their own in one or two months.

16. Juvenile Macular Dystrophy

Juvenile macular dystrophy refers to a group of inherited eye disorders that affect children and young adults. Juvenile macular dystrophy causes vision loss earlier in life and can lead to symptoms such as blurry and distorted vision, dark areas in vision and in later stages impaired colour vision. The three types of juvenile macular dystrophy are Stargardt disease, best’s disease and juvenile retinoschisis. According to the American Academy of Ophthalmology, there is currently no treatment for this disease. However, gene therapy may be a possible treatment that fixes the abnormal gene in the retina and may slow the progression of the disease.

17. Choroidal Neovascular Membranes

Choroidal neovascular membranes can develop due to the unusual growth of blood vessels from the capillaries of the choroid. Choroidal neovascular membranes continue to grow until they break through the retina and harm the macula as a result. Symptoms of choroidal neovascular membranes include a distorted view of objects, the appearance of straight lines with curves and difficulty in making out faces and objects and in later stages, a dark spot in the centre of vision (scotoma). Choroidal neovascular membranes typically require intravitreal injection of antiangiogenic agents, which can aid with reducing the growth of blood vessels.

18. Age-Related Macular Degeneration (AMD)

Age-related macular degeneration is an eye disease that causes a loss of central vision. Dry AMD is the most common form of AMD and is caused by age-related damage to the macula. Wet AMD is the less common, more severe type of AMD, that occurs when abnormal blood vessels grow in the eye, leading to damage to the macula. Age-related macular degeneration can cause distorted vision as symptoms include dark patches in central vision, blurred central vision, straight lines appearing wavy and difficulty distinguishing faces. Treatment for age-related macular degeneration depends on the extent of the condition and what type of macular degeneration is occurring. There is no effective treatment for early-stage dry macular degeneration. For more advanced AMD and for wet AMD, treatment prioritises maintaining vision and can include eating eye-healthy foods, AREDS2 supplements, photodynamic therapy (PDT), laser photocoagulation therapy and eye injections.

19. Pink Eye (Conjunctivitis)

Pink eye (conjunctivitis) is an inflammation of the conjunctiva which is a lining covering the white part of the eye. Pink eye can lead to distorted vision such as blurry vision as a result of excessive swelling and tears released among other symptoms such as pain, itchiness and discharge. Pink eye is most commonly caused by a viral infection, bacteria infection and allergies. Pink eye does not typically call for concern and may only require antibiotic or antihistamine eye drops prescribed by an optometrist.

20. Macular Pucker

A Macular pucker also known as an epiretinal membrane is a rare eye condition that can cause your vision to appear wavy or distorted and occurs when wrinkles or creases develop on the macula. Macular pucker can lead to vision problems as the macula can only function optimally if it is in a flat position at the back of your eye, therefore, wrinkles and creases forming can impair your vision according to the American Academy of Ophthalmology. Other than the wavy appearance of vision, other symptoms may include difficulty seeing fine details, and a grey or cloudy area in your central vision. Treatments for macular pucker can include a type of surgery known as a vitrectomy if your symptoms are more severe. If you only have mild symptoms, you may not require treatment or you may just need to have your prescription updated as eye drops and laser surgery will not be effective according to the American Academy of Ophthalmology.

How Long Does the Average Duration of Vision Distortion Last?

The average duration of vision distortion may not be known as it can differ depending on the type of vision distortion occurring, the underlying eye condition and the severity of symptoms. Additionally, there may not be a sufficient amount of evidence to accurately establish the average duration for vision distortions.