Sudden Vision Changes: Possible Causes and Concerns

Q: Sudden Vision Changes: Possible Causes and Concerns

Hello, regarding your question： <br>1. <br>Generally, there are two types of brain lesions associated with the optic nerve. <br>The first type involves brain lesions that cause compression of the optic nerve, with symptoms primarily manifesting as visual field defects, such as lo

Vision problems

I would like to ask the doctor under what circumstances symptoms of optic nerve compression could cause a sudden increase in my eye prescription.
I primarily have issues with my eyes, but the ophthalmologist has not found any abnormalities.
Here are my symptoms:
1.
Recently, on two different occasions (one month apart), I felt a sudden increase in my eye prescription.
When I noticed the increase, I observed a pronounced black halo around white screens on my phone.
After the increase, the halo remained but was less noticeable.
2.
The prescription in both eyes has increased by about 50 degrees.
I can see near objects clearly and do not have double vision.
3.
My eyelids were slightly droopy the day before yesterday, but my eyeballs can move normally, and my pupils are not dilated.
I would like to ask the doctor:
1.
I previously had a CT scan of my brain, and the report indicated no lesions.
However, since contrast was not used, I am still somewhat concerned that a small brain tumor could be the cause, especially since I have been experiencing some headaches recently.
What are the specific symptoms of vision loss caused by a brain tumor? If only one pair of nerves is affected, will all symptoms of that nerve manifest, or will only one or two symptoms appear?
2.
In recent days, an X-ray examination revealed misalignment in the cervical vertebrae at levels 5, 6, and 7, but it seems that these are not the segments that would compress the nerves.
Can cervical spine issues potentially compress the optic nerve and cause changes in vision?
3.
What other causes could be responsible for my symptoms, and which direction should I take for further evaluation?

Mr. Wang, 30~39 year old female. Ask Date: 2023/06/29

Dr. Peng Shiwei reply Neurology

Hello, regarding your question:
1.
Generally, there are two types of brain lesions associated with the optic nerve.
The first type involves brain lesions that cause compression of the optic nerve, with symptoms primarily manifesting as visual field defects, such as loss of peripheral vision.
The second type involves lesions within the optic nerve itself, such as optic neuritis or optic nerve tumors.
These lesions can occur unilaterally or bilaterally and can affect vision.
An MRI is usually the best way to identify whether a single optic nerve is affected, primarily presenting with the aforementioned symptoms.
If other cranial nerves that control eye movement (which have different pathways than the optic nerve) are also affected, this may lead to issues with eye movement and eyelid function.
2.
As for cervical spine lesions, you should first consider whether you have any motor symptoms, such as weakness or numbness on one side of the body.
If you do not have these symptoms, there is likely no need to worry about cervical spine involvement.
There is a condition known as neuromyelitis optica (also referred to as Devic's disease) that affects both the optic nerve and the spinal cord, but similarly, if you have this condition, you would typically present with motor symptoms.
3.
If you are still concerned, I recommend discussing with an ophthalmologist whether there are any other potential explanations for your sudden decline in vision or if an MRI is necessary.
Thank you for your inquiry.

Reply Date: 2023/06/29

More Info

Sudden changes in vision can be concerning and may arise from various underlying causes. Your symptoms, including a sudden increase in eyeglass prescription, visual disturbances such as halos around lights, and mild eyelid drooping, warrant careful consideration. Here’s a breakdown of potential causes and recommendations for further evaluation.

Possible Causes of Sudden Vision Changes
1. Optic Nerve Compression: This can occur due to various reasons, including tumors, inflammation, or vascular issues. If the optic nerve is compressed, it can lead to visual disturbances and changes in vision. Symptoms of optic nerve compression may include blurred vision, loss of peripheral vision, and changes in color perception. If a tumor is present, it may not always be detectable on a non-contrast CT scan, especially if it is small or located in a challenging area. MRI with contrast is often more sensitive for detecting such lesions.

2. Cervical Spine Issues: While cervical spine misalignments (like those you mentioned at C5, C6, and C7) typically do not directly affect the optic nerve, they can lead to referred pain or discomfort that might be perceived as visual changes. However, significant cervical spine issues can affect the blood supply to the brain and, in rare cases, lead to neurological symptoms. If there is compression of the vertebral arteries, it could potentially lead to visual disturbances.

3. Refractive Changes: Sudden changes in vision can also be due to changes in the eye's refractive state. This can happen due to conditions like diabetes, which can cause fluctuations in blood sugar levels, leading to temporary changes in vision. Additionally, changes in the lens of the eye, such as the onset of cataracts, can also cause visual disturbances.

4. Neurological Conditions: Headaches accompanied by vision changes can be indicative of neurological issues. Conditions such as migraines can cause transient visual disturbances, including aura symptoms that may resemble halos or other visual anomalies. If you are experiencing persistent headaches, it is essential to discuss this with your healthcare provider.

Recommendations for Further Evaluation
1. Comprehensive Eye Examination: Since you have already had a CT scan, it would be prudent to have a thorough eye examination by an ophthalmologist. This should include a dilated fundus examination to assess the optic nerve and retina for any abnormalities.

2. MRI of the Brain: Given your concerns about a possible brain tumor and the presence of headaches, an MRI of the brain with contrast would be a more definitive test to rule out any intracranial pathology.

3. Neurological Consultation: If your symptoms persist or worsen, consider consulting a neurologist. They can evaluate your headaches and visual symptoms in the context of potential neurological disorders.

4. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their duration, and any associated factors (like stress, fatigue, or dietary changes). This information can be valuable for your healthcare provider.

Conclusion
In summary, sudden changes in vision can arise from various causes, including optic nerve issues, cervical spine problems, refractive changes, and neurological conditions. Given your symptoms and concerns, it is crucial to pursue further evaluation with both an ophthalmologist and potentially a neurologist. Early diagnosis and intervention can significantly impact outcomes, so do not hesitate to seek care.

Similar Q&A

Understanding Sudden Visual Disturbances: Causes and Solutions

Hello Doctor: Recently, I have experienced sudden episodes of blurred vision around my eyes, which clear up on their own within ten minutes. The "blurred" sensation I refer to is not a white fog, but rather a transparent ripple effect, as if I am seeing through water, m...

Dr. He Jianxian reply Ophthalmology
Hello, Miss: Thank you for your inquiry. I would like to address your question and provide the following advice: Your symptoms appear to resemble a type of migraine (not all migraines necessarily present with headache), characterized by visual disturbances in the eye, which can r...

Sudden Vision Loss in One Eye: Possible Causes and Solutions

Hello Doctor, one night last year, I suddenly noticed a decrease in vision in my right eye when I got up. During the day in bright light, it feels okay, but in dim light at night, the blurriness in my right eye is very noticeable. This situation has persisted for over a year; it ...

Dr. Gao Pilin reply Ophthalmology
Hello: Based on the situation you described, sudden vision loss may involve various potential causes. Some possibilities include: 1. Glaucoma: Glaucoma can lead to vision loss and peripheral vision impairment, which may be more pronounced in low-light conditions. 2. Cataracts: Ca...

Sudden Double Vision Upon Waking: Causes and When to Seek Help

This morning, I woke up and saw two air conditioners, which made me very anxious. However, after a minute, it returned to normal. Could it be due to the fact that I didn't sleep at all last night and was crying a lot, causing eye fatigue? Or could it be a problem with my ner...

Dr. Gao Pilin reply Ophthalmology
Hello: Temporary visual disturbances may not necessarily indicate a problem with the brain, and this condition could be related to your lack of sleep and emotional stress. Eye fatigue and prolonged crying can lead to temporary blurriness or distortion of vision. Additionally, env...

Understanding Blurry Vision: Causes and Concerns for Eye Health

I'm sorry, Dr. Gao. If the reasons you mentioned could be ambiguous, could there be a possibility that the left eye's vision has decreased while astigmatism has appeared, and the right eye's vision has increased, all occurring within just a few days? Or could there...

Dr. Gao Pilin reply Ophthalmology
Hello: Based on your description, the changes in your vision and the onset of astigmatism may be the result of multiple factors. Here are several possibilities: 1. Vision Fluctuations: Short-term fluctuations in vision may be caused by eye strain, dry eye syndrome, or irreg...