Changes in vision can range from mild to severe, and may be lasting or only temporary. For example, a person may become completely blind or may have poor vision only under certain conditions.
Common vision changes can include - but are not limited to:
Vision changes can be caused by anything from normal aging to life-threatening conditions. The exact changes in the body will depend on the specific cause and type of vision change.
The possible causes of vision changes include:
Other causes of vision changes are possible. Sometimes, no cause can be found.
Kinds of vision changes include:
A history and physical exam, including an examination of the eye, are done first. In an eye exam, the person may be asked to read an eye chart. Special instruments may be used, and the pressure inside the eye may be measured. Eye drops can be put into the eye to make the pupils get bigger. This helps the doctor see the inside of the eye better.
The doctor will also need to know the kind of vision changes the person has noticed as well as:
In addition, the doctor may ask about other symptoms, such as:
These steps may be all that's needed to make the diagnosis. In other cases, further testing is needed.
The tests that are ordered vary, depending on the suspected cause. A cranial CT scan may be done if a brain tumor or stroke is suspected. A blood test can help diagnose temporal arteritis or diabetes.
Prevention depends on the cause. Early detection and treatment of glaucoma can often prevent vision loss. Control of diabetes can help prevent vision changes caused by diabetic retinopathy. Frequent hand washing and not touching the eyes with the hands helps prevent conjunctivitis. Many cases of vision changes cannot be prevented.
Long-term effects depend on the cause. Presbyopia causes a permanent loss of vision in near objects. But reading glasses or bifocals are the only treatment needed and there are no other long- term effects. A brain tumor can cause death. Glaucoma, macular degeneration, and diabetes can all result in permanent blindness or vision changes.
Vision changes themselves pose no risks to others unless the person engages in dangerous activities such as driving. If the cause of the vision change is an eye infection, such as conjunctivitis or keratitis, the infection may be catching in some cases.
Treatment is directed at the cause. Medicines are often used to control diabetes or glaucoma. Retinal detachment, cataracts, some types of glaucoma, and brain tumors can be treated with surgery. Eye infections may need to be treated with antibiotics. Nearsightedness is usually treated with glasses or contact lenses.
Side effects depend on the treatments used. All medicines may have side effects. For example, those used to control diabetes may cause liver damage or allergic reactions. Surgery carries a risk of bleeding, infection, or loss of vision. Contact lenses may irritate the eyes or result in eye infections.
Treatment varies according to the cause of the vision change. After a person gets glasses, no further treatment may be needed aside from periodic checkups. People who have diabetes or glaucoma usually need close monitoring and treatment for life. Macular degeneration often causes vision to get worse over time, so treatment may change.
The doctor should be told about any changes in vision or the responses to treatments. Repeat eye exams are advised for many causes of vision changes. Children with a lazy eye may need close monitoring along with surgery, special glasses, or a patch over one eye.
Author:Adam Brochert, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:09/29/02
Reviewer:Kathleen A. MacNaughton, RN, BSN
Date Reviewed:09/29/02
Cecil Textbook of Medicine, 1996, Bennett et al.
Harrison's Principles of Internal Medicine, 1998, Fauci et al.