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.
The medication given for vertigo has a side effect of blurry vision. This will be more of a constant feeling but may get more or less intense closer to the time you take the medication.
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.
Disclaimer
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.
I was taught the Epley maneuver to help with my vertigo. I do it for the right side snd it helps immensely. Right now I am having difficulty reading. I seems that my eyes are focusing on two different sentences and the letters from the two sentences get mixed up. if I do the Epley maneuver, I am able to read clearly again. with the pandemic I am sheltering at home. I’ve read about some apps that may help. I am looking for advice and help that I can do from home.
Hi Mania,
I am sorry to hear what you are going through!
I do not teach or recommend for people to do the Epley maneuver on their own.
Here are two relevant blogs I published on 5 Reasons the Epley Maneuver does not Work and Eight Common Pitfalls of Trying to Treat Yourself.
My suggestion is search for a Vestibular Provider in Your Area.
With proper COVID-19 precautions in place, you should be able to find and access skilled vestibular care.
I’ve seen my GP and an ophthalmologist who say all looks normal yet I continue to have random blurred vision, woozy, feel off-balance throughout the day. Who should I see next, to determine if it’s vestibular or eye issues? Thank you!
Hi Kath,
I suggest you see a Vestibular Physical Therapist. You can use this blog to find one in your area.
Also, you may want to see a Neuro-Optometrist, if you still have symptoms after completing the vestibular physical therapy treatment plan. You can find this type of specialist at COVD.org.
I hope that helps!
Don’t give up!
Best wishes,
Kim Bell, DPT
Hello,
I was diagnosed with BPPV from the lateral canal 2 months ago. I’ve been going to therapy and getting better, but ever since my vertigo I have been seen a lot of eye floaters to the point that they annoy me. Before my episode I saw the occasional eye floater, but not like this, this started quite acutely. Could this be do to a problem with my VOR?
I am 30 years old, so I don’t think the aging would have to do with the eye floaters.
Thank you
Hi Laura,
You are correct that floaters can be due to normal aging of the eyes.
Floaters with flashes of light can indicate a retinal detachment.
VOR issues do not usually involve floaters, to answer your question.
VOR issues have to do with external control over the position of the eye, with regards to the vestibular sensory apparatus and the reflexive response of the eye muscles to position the eyeball within the socket. That is an “extra-ocular” problem,” which is caused by body parts outside the eyeball itself that create retinal slip of the image when you turn your head and result in blurry vision, or oscillopsia.
Whereas, floaters usually indicate an “intra-ocular” issue, that is within the eyeball.
I suggest for you to see an Ophthalmologist for a comprehensive eye exam.
Best wishes,
Kim Bell, DPT
i have vertigo for about 3 months now the dizziness has gotten alot better but i have constant blurred vision that started when i first got vertigo
i have been doin VR therapy but i havent noticed a difference yet been 3wks
will this get better in time or will this be the new norm for me
Hi Paul,
If you have been doing VR for 3 weeks and you don’t feel the blurry vision is getting any better, then you may want to either:
1) See a more experienced VR PT for a second opinion – to make sure nothing has been missed.
You can use this blog to find vestibular providers in your area.
2) See a Neuro-Optometrist. You can find one using the doctor locator tool at COVD.org.
If you were attacked by a virus, for example, then the virus that attacked your inner ear can also attack the nerves that control eye function. That is where a Neuro-optometrist can help.
You may need to do vision therapy in addition to or instead of vestibular therapy, to get relief from the blurry vision.
You can also check out this blog and this blog, where I write about common barriers to vestibular recovery.
Perhaps you are dealing with a specific barrier that is limiting your progress with VR PT? If so, I suggest you discuss the blog topic with your VR PT to brainstorm ways to overcome the suspected barrier and continue your VR PT treatment plan.
I hope that helps!