If your vision is blurry, the first two professionals to consult are most likely your primary care physician and your eye doctor.
The eye doctor can check your vision to see if you need new glasses.
If you have recently gotten new glasses, it is possible the prescription is not correct. You may be not tolerating bifocals, trifocals, or progressive lenses, if they are new to you.
You can discuss all those possibilities with the eye doctor who checks your distance and close up vision.
There are other possible reasons for blurry vision.
In this blog, I discuss a few less commonly discussed ideas about blurry vision.
Are your eyes unfocused while your head is still, or while your head is in motion?
That is an important question.
The key to determining the root cause of blurry vision is to determine when it occurs and what other symptoms are present.
This detailed information will help your doctors to determine if the blurry vision is from the eyes, the brain, the inner ear, medication side effects, some combination of those, or some other reason.
If your eyes are out of focus and you have blurry vision while the head is at rest, you likely need to see two different doctors. You may want to consult an ophthalmologist to check for eye problems like cataracts or other eye diseases. You may also want to see a neurologist to check for brain problems.
A neuro-ophthalmologist may be able to help with checking both the eyes and the brain.
The neurologist or neuro-ophthalmologist would especially be indicated if you lose any part of your visual field, like say half of your visual field is cut off.
Your primary doctor will be able to advise you on which specialist medical doctors will be helpful to consult.
Floaters & Blurry Vision
Intermittent floating lights in the visual field could be associated with the vestibular migraines or ocular migraines. These should go away when the migraine episode is over.
Constant floaters in the visual field may be from normal aging of the eye.
Floaters with flashes of light in the peripheral vision could indicate a retinal detachment. This symptom is important to have checked out by an ophthalmologist who can look at your retina.
Vestibular Ocular Reflex (VOR)
Relatively constant blurry vision may be potentially due to seasonal allergies or side effects of medications that cause blurry vision, like meclizine. Your primary care doctor may be helpful to resolve the blurry vision issue in that case.
If your vision gets blurry while your head is in motion, that’s most likely an inner ear or vestibular problem. That indicates a problem with the vestibular ocular reflex (VOR) which is the fastest reflex in the body.
When the VOR is working properly, you should never lose the focus of your eyes while your head is turning quickly. If that is happening even for a split second, you may have a vestibular problem.
There are many problems with the inner ear that can cause this momentary delay in VOR. Some examples include acute viral infections, old viral infections that caused permanent damage, side effects of medications that damage the ear, vestibular hypofunction, and BPPV crystals in the ear.
A proper evaluation by a vestibular specialist is needed if the vision gets blurry – even for a moment – when the head turns quickly. This is important to address with vestibular rehabilitation because this problem is a common cause of falls.
Can Vertigo Cause Blurry Vision?
Yes! You can have blurry vision in the acute phase of vestibular neuritis or labyrinthitis due to oscillopsia. This may last a few days and gradually improve as you begin to feel better.
If you experiencing positional vertigo due to BPPV, you can have blurry vision due to oscillopsia. In this case, the blurry vision will be triggered by certain movements or positions, like lying down or rolling over in bed. It only lasts about a minute and may feel better as the day goes on.
People with vestibular hypofunction that is not fully compensated or have decompensated may also have impaired VOR. They may have momentarily blurred vision when they turn quickly.
In extreme cases of vestibular hypofuntion or with vestibular loss, people can get blurry vision every time they chew or with each heartbeat. This symptom represents an extremely poor VOR.
If vertigo has co-occuring neurological signs like slurred speech, blurred vision, or double vision, it can be from “vascular vertigo.” This type of vertigo would constitute a medical emergency. It may last for only a few minutes or get progressively worse. This can be serious because it may be a TIA or a prodrome to a larger stroke.
The bottom line is that the link between the eyes, the inner ear, and the brain is so complex that people with blurry vision should seek medical care from professionals.
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.