Common Eye Issues: Vision Distortions and Prescription Needs

Q: Common Eye Issues: Vision Distortions and Prescription Needs

Hello, Ant： 1. <br>A slight waviness may not be indicative of macular degeneration. <br>Sometimes, it could also be related to refractive issues. <br>2. <br>It is possible that there is a refractive problem, causing the image projected near the blind spot to appear somewhat disto

I have several questions regarding vision?

I have a few questions that have persisted for several years: 1.
When I focus on a straight line with my right eye alone, it appears slightly distorted, with a subtle wavy sensation.
The Amsler grid test seems fine.
The images of macular degeneration I found online are quite exaggerated, so I'm unsure if this mild distortion indicates a problem.
I have annual fundus examinations, and they have all reported no issues.
2.
There is a confirmed distortion near the blind spot in my right eye.
However, a previous doctor mentioned that if it's not in the central visual field, it isn't macular degeneration, and the blind spot should be invisible, so I'm uncertain why there is a distortion.
My left eye is fine.
3.
Currently, my left eye has a higher degree of myopia, but my right eye has more astigmatism than my left.
Both eyes are around -8.00 diopters for myopia, with the right eye having approximately -1.50 diopters of astigmatism.
My glasses were prescribed a few years ago; after wearing them, my left eye's vision is quite good, but my right eye has gradually worsened.
The right eye becomes very blurry in low light conditions.
In bright sunlight, it is relatively clear.
However, in indoor lighting, during the evening, or in darker places, it becomes less clear.
It seems that my right eye appears slightly yellowish and darker than my left.
I have consulted several ophthalmologists, and their opinions vary.
Some suggest optic nerve degeneration, while others say it is merely fatigue.
I initially thought there was no hope, but later, when I tried looking through the left eye's lens, I could still see clearly, indicating that my prescription might be insufficient.
But can pure myopia cause this? Or is it due to astigmatism? Additionally, I notice that my vision is clearer in the early morning, but after about an hour of being awake, it starts to become unclear.
Is it still possible at my age for my myopia to worsen and require a new prescription?

Ant, 30~39 year old female. Ask Date: 2022/04/18

Dr. Gao Pilin reply Ophthalmology

Hello, Ant: 1.
A slight waviness may not be indicative of macular degeneration.
Sometimes, it could also be related to refractive issues.
2.
It is possible that there is a refractive problem, causing the image projected near the blind spot to appear somewhat distorted.
3.
This may be a phenomenon of insufficient prescription; both myopia and astigmatism can cause this.
Inadequate lighting can lead to blurriness, and getting new glasses may improve the situation.

Reply Date: 2022/04/18

More Info

It sounds like you are experiencing a range of visual disturbances that could be linked to several underlying issues, including refractive errors, potential retinal concerns, or even fatigue-related symptoms. Let’s break down your concerns and provide some insights based on common eye issues and the importance of proper vision correction.

1. Distortion in Vision: The sensation of straight lines appearing wavy or distorted, especially when viewed with one eye, can be indicative of several conditions. While you mentioned that the Amsler grid test appeared normal, which is a good sign for macular health, it’s important to consider that subtle distortions can still occur. These could be related to minor retinal changes or even issues with the cornea or lens. If the distortion is persistent, further evaluation by an eye care professional may be warranted, possibly including imaging studies like Optical Coherence Tomography (OCT) to assess the retina in more detail.

2. Blind Spot and Distortion: The presence of distortion near your blind spot can be perplexing. Typically, the blind spot is an area where the optic nerve exits the eye, and it does not register visual information. However, if you are perceiving distortion in this area, it may be due to the way your brain processes visual information from both eyes. It’s also possible that there are subtle changes in the retina or optic nerve that could be contributing to this perception. A comprehensive eye exam, including visual field testing, could help clarify this issue.

3. Refractive Errors: Your description of having significant myopia (near-sightedness) and astigmatism in your right eye suggests that your current prescription may indeed need updating. It’s not uncommon for refractive errors to change over time, especially if you are experiencing visual fatigue or strain. The fact that your vision is clearer in bright light but deteriorates in dim conditions could indicate that your right eye is struggling to focus properly due to the combination of myopia and astigmatism.
4. Age-Related Changes: As we age, our eyes undergo various changes that can affect vision. This includes the potential for increased myopia or changes in the lens that can lead to presbyopia (difficulty focusing on close objects). It’s entirely possible for your myopia to worsen, necessitating a new prescription for glasses. Regular eye exams are crucial, especially if you notice changes in your vision.

5. Fatigue and Visual Clarity: The observation that your vision is clearer in the morning but worsens after a few hours of activity could be a sign of visual fatigue. Prolonged screen time or reading can lead to eye strain, especially if your prescription is not optimal. Ensuring that you take regular breaks, practice the 20-20-20 rule (looking at something 20 feet away for 20 seconds every 20 minutes), and maintaining proper lighting can help alleviate some of this strain.

In conclusion, it is advisable to schedule a comprehensive eye examination with an eye care professional who can assess your current prescription and evaluate any potential underlying issues. Given your symptoms and the complexity of your visual experiences, a tailored approach to your eye care is essential. Regular monitoring and adjustments to your prescription can significantly enhance your quality of life and visual comfort.

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