Gradual Vision Loss: Seeking Answers for Blurry Sight

Q: Gradual Vision Loss: Seeking Answers for Blurry Sight

Hello Tony： If all the tests have been done and some diseases have been ruled out, however, based on your description, it seems somewhat like an issue related to retinal pigment degeneration. <br>I wonder if this diagnosis has already been excluded? In Taiwan, the Department of O

I have been gradually experiencing blurred vision for the past three years?

I am 30 years old and about three years ago, I suddenly noticed that my vision became somewhat blurry without my glasses.
Previously, I did not need to wear glasses for daily activities like seeing and driving, whether during the day or at night.
Three years ago, I was prescribed glasses with -0.50 diopters for my left eye and -0.75 diopters for my right eye, and although I have about -0.50 diopters of astigmatism in both eyes, I could still see clearly (1.0 or better) without correction.
Initially, I thought the blurriness was just due to worsening myopia, and since I could see clearly with my glasses, I didn't think much of it.

During this period, I still didn't need to wear glasses for driving in both day and night, although I started needing them in dim indoor settings or when trying to see the blackboard in class.
However, over the past two to three years, I have experienced a significant decline in my vision, which feels like a "sliding scale" of deterioration.
Even with my glasses, things don't seem as clear, and my prescription has gradually increased each year.
As of a few days ago, I needed a prescription of -1.25 diopters for both eyes with -0.50 diopters of astigmatism to see clearly.

The most notable change in my vision over the past six months is that even with glasses, the clarity is not satisfactory (although I can still read 1.0 on the vision chart).
At night, driving has become increasingly difficult, with everything appearing darker and oncoming headlights feeling more glaring.
I also feel that my field of vision has narrowed.
Over the past six months, I have consulted numerous ophthalmologists, both in clinics and medical schools, and have undergone a variety of eye examinations (essentially all available tests), yet no doctor has been able to identify the cause of my complaints.
Conditions such as glaucoma, cataracts, retinal issues, and macular degeneration have all been ruled out.
I am now feeling that my vision is slowly deteriorating each day, with colors appearing dull and an increasing sense of unclear brightness, both day and night, especially at night.
The key issue is that even with corrective lenses, I still feel that my vision is unclear and dim.
Oncoming headlights have become very glaring, and after countless consultations over the past six months, I am exhausted and at a loss for what to do next.
Could you provide some guidance on what direction I should take to seek further medical help, or suggest any other potential conditions that might be causing these symptoms?

Tony, 30~39 year old female. Ask Date: 2021/01/07

Dr. Gao Pilin reply Ophthalmology

Hello Tony: If all the tests have been done and some diseases have been ruled out, however, based on your description, it seems somewhat like an issue related to retinal pigment degeneration.
I wonder if this diagnosis has already been excluded? In Taiwan, the Department of Ophthalmology at Puzi Hospital is open on Monday, Tuesday, Thursday, and Friday mornings from 8:00 AM to 12:00 PM, and on Wednesday afternoons from 2:00 PM to 4:30 PM.
Please note that online responses can only serve as a reference; it is still necessary to seek medical attention at a healthcare facility.
I hope to have the opportunity to assist you.
Best regards, Gao Pilin.

Reply Date: 2021/01/07

More Info

It sounds like you are experiencing significant visual disturbances that have progressively worsened over the past few years. Given your history and the symptoms you describe, it is essential to consider several potential underlying causes for your gradual vision loss and blurry sight.
First, it is important to understand that vision changes can occur due to a variety of reasons, including refractive errors, cataracts, retinal issues, or even neurological conditions. Since you have already undergone extensive testing to rule out common conditions such as glaucoma, cataracts, retinal detachment, and macular degeneration, we can explore some other possibilities.

1. Refractive Errors: While you mentioned that you have been diagnosed with mild myopia and astigmatism, it is possible that your refractive error has changed more significantly than what is being corrected by your current glasses. It is also worth noting that some individuals may experience changes in their vision due to the aging process, even at a relatively young age.
2. Cataracts: Although you have been told that cataracts are not present, it is worth considering that early-stage cataracts can sometimes be difficult to detect. Cataracts can cause blurred vision, increased sensitivity to glare, and difficulty seeing at night. If you have not had a thorough examination specifically looking for cataracts, it may be beneficial to seek a second opinion from a specialist who focuses on cataract surgery.

3. Retinal Issues: Conditions such as retinal tears or detachments can lead to visual disturbances, including blurriness and changes in peripheral vision. Even if previous examinations did not reveal any issues, it may be worthwhile to have a more detailed evaluation, including optical coherence tomography (OCT), which provides cross-sectional images of the retina.

4. Neurological Factors: Sometimes, visual disturbances can stem from neurological issues, such as optic neuritis or other conditions affecting the optic nerve. If you have not yet seen a neurologist, it may be beneficial to do so, especially if you have any accompanying symptoms such as headaches or changes in coordination.

5. Visual Processing Disorders: In some cases, individuals may have normal eye health but experience difficulties with visual processing. This can lead to symptoms such as blurriness or difficulty focusing, particularly in low-light conditions. A neuro-ophthalmologist can help assess whether this might be a contributing factor.

6. Environmental Factors: Consider whether there are any environmental factors that might be affecting your vision, such as prolonged screen time, poor lighting conditions, or even stress and fatigue. These can all contribute to visual discomfort and may exacerbate underlying issues.

7. Lifestyle and Nutrition: Ensure that you are maintaining a healthy diet rich in antioxidants, vitamins, and minerals that support eye health, such as Vitamin A, C, E, lutein, and omega-3 fatty acids. Staying hydrated and managing any systemic health issues (like diabetes or hypertension) is also crucial for maintaining good vision.

Given the complexity of your symptoms and the lack of a clear diagnosis, I recommend seeking a comprehensive evaluation from a specialized eye care center or a university-affiliated clinic where you can access a multidisciplinary team. They may offer advanced diagnostic tools and a fresh perspective on your condition.

In summary, while it can be frustrating to not have a definitive answer, continuing to advocate for your health and seeking further evaluations is essential. Keep a detailed record of your symptoms, including when they occur and any changes you notice, as this information can be invaluable for healthcare providers in diagnosing your condition.

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