Unexplained Blurry Vision: Causes and Solutions

Blurred vision with an unknown cause?

Hello Dr.
Tsai: My husband (45 years old) has experienced significant vision deterioration over the past few years.
He went to a large hospital for an eye examination, and the doctor mentioned that his prescription had deepened.
Initially, both eyes had a prescription of -650 diopters, but after the examination, the right eye increased to -1000 diopters.
However, no matter how the optometrist measured the left eye, the corrected vision could only reach 0.7 and could not improve to 1.0.
The doctor honestly stated that they did not know why this was happening and suggested that my husband return for a follow-up examination after some time to see if it was temporary.

After six months, we went to another ophthalmology clinic for a check-up, and the diagnosis was: approximately 50% cataract in the right eye (which had surgery two months ago), while the left eye still had unexplained vision issues that could not be corrected beyond 0.7.
Is this examination result considered abnormal, and is it truly unmanageable? He needs to get new glasses soon, but with the corrected vision at 0.7 compared to 1.0, he experiences double vision at certain distances when trying on glasses.
The doctor could not provide an explanation for this, and we wonder if it is due to the disparity in vision between the two eyes.
Thank you for taking the time to answer!

Zhenni, 40~49 year old female. Ask Date: 2016/08/26

Dr. Cai Wenyuan reply Ophthalmology

Cataracts can indeed worsen refractive error, and there are many reasons for poor vision, making it difficult to diagnose without proper examination.
If the cause cannot be identified, it is recommended to visit a medical center for evaluation.
Thank you.

Reply Date: 2016/08/26

More Info

Hello! Thank you for sharing your husband's situation regarding his vision issues. It sounds quite concerning, especially with the significant changes in his eyesight and the challenges he is facing with corrective lenses. Let's break down the potential causes and solutions for the unexplained blurry vision and the difficulties he is experiencing.

Understanding Blurry Vision and Its Causes
1. Refractive Errors: The most common cause of blurry vision is refractive errors, which include myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Your husband has experienced a significant increase in myopia, which can lead to blurry vision if not corrected properly. The fact that his right eye has progressed to 1000 degrees indicates a severe level of myopia, which can complicate vision correction.

2. Cataracts: You mentioned that your husband has about 50% cataract formation in his right eye, which he has already had surgery for. Cataracts can cause blurry vision, glare, and halos around lights. Even after surgery, if the lens is not perfectly clear or if there are complications, it can lead to persistent vision issues.

3. Amblyopia or Lazy Eye: If one eye has significantly poorer vision than the other, it may not respond well to corrective lenses. This condition, known as amblyopia, can occur if the brain favors one eye over the other, leading to a situation where the weaker eye cannot achieve normal vision even with correction.

4. Retinal Issues: Conditions such as retinal detachment, macular degeneration, or other retinal diseases can also lead to unexplained blurry vision. These conditions may not always be detected in standard eye exams, so further testing may be necessary.

5. Optical Quality: Sometimes, the quality of the lenses used in glasses can affect vision. If the lenses are not of high quality or if they are not properly fitted, it can lead to visual distortions, including double vision or blurriness at certain distances.

Solutions and Recommendations
1. Comprehensive Eye Examination: It is crucial for your husband to undergo a thorough eye examination by an ophthalmologist, especially one who specializes in complex cases. This should include tests for retinal health, optical coherence tomography (OCT), and possibly a visual field test to assess how well each eye is functioning.

2. Corrective Lenses: If your husband is experiencing double vision or blurriness at certain distances, it may be beneficial to try different types of corrective lenses. Bifocals or progressive lenses could help if he has different vision needs for near and far distances. Additionally, prism glasses may be considered if the double vision is due to misalignment.

3. Follow-Up on Cataract Surgery: Since he has had cataract surgery, it’s important to follow up with the surgeon to ensure that the surgery was successful and that there are no complications such as posterior capsule opacification, which can cause blurry vision after cataract surgery.

4. Vision Therapy: If amblyopia is suspected, vision therapy may be an option. This involves exercises designed to improve coordination and focus between the two eyes.

5. Lifestyle Adjustments: Encourage your husband to take regular breaks from screens and to practice good eye hygiene. Proper lighting while reading or working can also help reduce eye strain.

6. Regular Monitoring: Given the complexity of his situation, regular monitoring of his vision and eye health is essential. This will help catch any changes early and adjust treatment as necessary.

Conclusion
Your husband's situation is indeed complex, and while it may be frustrating not to have clear answers, there are several avenues to explore. It’s important to remain proactive in seeking further evaluations and to communicate openly with eye care professionals about any changes in his vision. With the right approach, there is hope for improvement or at least stabilization of his vision. Please encourage him to stay positive and to continue seeking the best care possible.

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