introduction

Visual disturbances in general denote a change in visual perception. There are a variety of diseases that can lead to vision problems. This includes not only diseases of the eye, but also neurological diseases or masses (tumors). Whether a visual disorder persists or improves again depends largely on the underlying disease.

causes

Visual disturbances can have a variety of causes. This includes not only diseases of the eye itself, but also neurological diseases or tumors. But diseases that manifest themselves all over the body, such as high blood pressure or diabetes, can lead to visual disturbances.

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Diseases of the eye that make themselves felt as visual disturbances can be, for example, glaucoma (glaucoma), cataracts or a detachment of the retina.

But also infectious causes can be considered to trigger visual disturbances. Viruses or bacteria can inflame the optic nerve and lead to impaired vision. An example of this would be the zoster opthalmicus. This is an infection of the eye with the varicella zoster virus, a herpes virus.

Non-infectious inflammations such as multiple sclerosis, lupus erythematosus or rheumatoid arthritis can also cause visual disturbances.

Metabolic disorders, such as an underactive or overactive thyroid, a vitamin A deficiency or a vitamin B12 deficiency can also lead to visual disturbances.

In addition to these causes, vascular diseases, medication or traumatic events can also lead to visual disturbances.

Visual disturbances in multiple sclerosis

Visual disturbances are a common symptom of multiple sclerosis. In a third of people with multiple sclerosis, visual impairment is the first sign of the disease.What is noticeable here is that the visual disturbances repeatedly occur temporarily.

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However, patients with known multiple sclerosis can also suffer from visual disturbances. Statistically, three out of four patients suffer from visual disturbances in the course of their illness. The visual disturbances often result from inflammation of the optic nerve as part of the disease. Inflammation of other cranial nerves can also lead to impaired vision.

The visual disturbances can express themselves primarily through reduced vision, a changed color and contrast perception, double images or blurred vision.

Medicines with anti-inflammatory effects, such as cortisone, are available for therapy.

If the symptoms occur in a known multiple sclerosis or if multiple sclerosis is suspected, you should see a doctor as soon as possible.

Read more on the subject at: Optic nerve inflammation in MS

Visual disturbance during a stroke

Visual disturbances that occur as part of a stroke are expressed as a sudden onset. They express themselves primarily through a restriction of the field of vision, a disruption of spatial vision and the appearance of double images.

Often the visual disturbances are not the only symptom. Other symptoms can include speech disorders, paralysis or numbness, dizziness and unsteadiness of walking, severe headaches. It is characteristic that the symptoms appear suddenly in a stroke.

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If a stroke is suspected, the ambulance service should be called immediately, as the time until arrival at the hospital and the start of therapy can be decisive for the prognosis.

Read more on the subject at: Stroke in the eye

If the vision problems persist after a known stroke, you can find more information here: Impaired vision after a stroke

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Visual disturbances in migraines

Visual disturbances are very common with migraines. They are known as the so-called aura and often occur right before a migraine attack. The visual disturbances in the context of an aura can express themselves in different ways. Characteristic are light flashes, flickering zigzag lines, blind spots or double images.

Other symptoms that are also part of a migraine with aura can include:

  • Visual field loss

  • Optical perception disorders (scotomas)

  • Failure symptoms (paralysis)

  • Sensory disturbances (tingling or numbness)

  • Word-finding or educational disorders

  • dizziness

  • Tinnitus

  • Hearing loss

A general distinction is made between forms of migraine with and without aura. This means that not everyone who suffers from migraines also has visual disturbances or other symptoms of an aura before a migraine attack. An aura can also occur without a subsequent headache.

Many migraineurs recognize these characteristic symptoms and know that a migraine attack can occur quickly.

Read more on the subject at: Migraine attack

Vision problems from stress

In the case of a high level of stress, it can happen that contrasts are perceived differently or, for example, reading becomes more difficult. Often one also has a burning and dry feeling. Once the stress subsides, these symptoms often go away on their own.

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It is believed that stress can also be a risk factor for a fairly rare disease. It is called retinopathia centralis serosa or central serous retinal damage. It occurs mainly in men between the ages of 30 and 50, who are exposed to high levels of stress. It is manifested by a sudden deterioration in vision and distorted perception. An increased concentration of stress hormones can often be detected in the blood. The exact cause of this disease is still unknown. The disease often resolves completely within a few weeks.

Visual disturbances due to psychological stress factors

Visual disturbances can also occur in the context of mental illness or increased mental stress. In the case of psychological stress, it is often difficult to see, the eyes feel dry and burning. Visual field defects, for example, are also characteristic.

Visual disturbances in the context of mental illnesses can express themselves very differently due to the range of different illnesses in this specialist area.

Vision problems from diabetes

In the context of diabetes mellitus, there is often a deterioration in eyesight. It is one of the most common causes of blindness in adulthood.
The disease often goes unnoticed for a long time. The disease causes damage to the optic nerve and the retina. The vessels that supply the retina become hard and brittle due to diabetes. The condition is known as diabetic retinopathy. A cataract can also be favored by diabetes.

Vision problems with a brain tumor

Basically, brain tumors are a rare cause of visual disturbances. Whether a brain tumor leads to visual impairment depends on the location of the tumor. Tumors of the pituitary gland, in particular, can lead to visual disturbances, as they can press on the nerves of the visual pathway. This can be noticeable as flickering in front of the eye, loss of the field of view or double vision.

Tumors that lead to increased pressure in the brain can also lead to visual disturbances. Symptoms such as dizziness, imbalance, nausea or vomiting may also occur.

Read more on this topic at: These symptoms suggest a pituitary tumor

Visual disturbances during pregnancy

Visual disturbances during pregnancy are possible. They are often harmless and self-limiting. Often times, a little fluid also collects in the lens and cornea during pregnancy. This changes the refractive power and thus also the eyesight. As a rule, the visual disturbances regress after birth.

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However, they can also occur in the context of so-called gestational diabetes (gestational diabetes) or preclampsia. The latter is a very rare but serious disease. It is characterized by high blood pressure and proteinuria, which is an increased excretion of proteins in the urine. Those affected often express lightning bolts in front of their eyes or describe parts of their field of vision as appearing black. Sudden, frequently changing visual acuity is more indicative of gestational diabetes.

It is advisable to consult a doctor in any case if you have visual disturbances during pregnancy.

diagnosis

In the event of acute, sudden visual disturbances, you should present yourself to the emergency room or a medical on-call service. If the visual disturbances have existed for a long time or are gradually worsening, you should consult an ophthalmologist as soon as possible.

The attending physician will ask you about the course of the disease and the exact symptoms. Further examinations will be performed depending on the possible cause that the attending physician considers likely. This can include an ophthalmological exam, a blood test, a neurological exam, or a CT / MRI scan.

Accompanying symptoms with visual disturbances

Depending on the cause of the visual disturbance, very different accompanying symptoms can occur.

Accompanying visual symptoms can be, for example, a change in color or contrast perception, loss of visual field, or double images. Flashes of light or blind spots can also occur.

In addition, in combination with visual disturbances, dizziness, nausea, vomiting or pain can occur.

Flicker before the eye

A “flicker in front of the eye” often occurs as part of an aura in migraines. An aura often precedes the severe headache of a migraine attack. But it is also possible without a headache. Not all migraines start with an aura. A distinction is therefore made between a migraine with and a migraine without aura.

Read more on the subject at: Eye flicker - is it dangerous?

Dizziness with impaired vision

Visual disturbances can also be accompanied by dizziness. Examples of visual disturbances combined with dizziness can be fainting, blood pressure that is too high or too low, hypoglycaemia or even a stroke.

Unilateral visual disturbances

Visual disturbances can also occur unilaterally. They can appear suddenly or gradually. Examples of the cause of one-sided visual disturbances can be astigmatism, cataracts or multiple sclerosis.

A sudden unilateral loss of vision that does not cause pain can indicate an occlusion of the vessel that supplies the retina (so-called central artery occlusion).

Therapy of visual disturbances

Treatment for visual disturbances depends on the underlying cause.

If the visual disturbances occur as part of a migraine, there is no therapy option to treat them. Visual performance often returns to normal within a short period of time. In the event of headaches and nausea during a migraine attack, pain relievers and anti-emetic drugs can be taken.

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If the visual disturbances occur due to a too low or too high blood pressure, the visual disturbance often normalizes itself when the blood pressure is back in the normal range. It may be necessary to take medication to adjust blood pressure.

If visual disturbances occur in the context of a too low blood sugar, one should consume glucose or fruit juices to increase the blood sugar again. The visual disturbances usually normalize on their own.

If you have farsightedness or nearsightedness or astigmatism, you should wear glasses to improve visual performance.

How long do visual disturbances last?

How long the visual disturbance lasts depends on the cause. Some vision problems will normalize on their own, while others may require treatment until they improve.

If there is farsightedness or nearsightedness or astigmatism, glasses must be worn over the long term. Alternatively, there is often the option of laser treatment.


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