What is Peripheral Vision Loss?

Side vision loss affects eyesight outside the central field of vision, as a result of damage to the eye’s structures or a section of the brain responsible for sensory input.This damage may occur in conjunction with conditions affecting the rest of the body, or in the absence of any external complications.It can occur in one eye or both. Loss of side vision encompasses eyesight to the sides and above and below our central line of vision. It can occur suddenly or gradually, so it may be difficult to detect.

What is Peripheral Vision Loss? in

What Type of Medical Condition Causes Peripheral Vision Loss?

While peripheral vision loss can sometimes be congenital, occur secondary to eye injuries or optic nerve damage, result from a stroke, or from medications,  it is most frequently caused by degenerative eye diseases such as Glaucoma:

  • Strokes: People who have strokes may experience a type of visual neglect known as hemeniaopsia, where they lose one half of their side vision, either on the right side or the left. People with hemianopsia can often be taught to scan their eyes in the direction of the deficit in order to compensate for the field loss or can have special prisms that redirect the images to compensate. 
  • Glaucoma: This is the primary cause of most cases of peripheral vision loss. It is caused by excessive intraocular eye pressure from fluid. If it is not treated it can lead to permanent vision loss.
  • Diabetic retinopathy: These include several types of eye complications involving retinal damage secondary to diabetes. In such instances, the eye's blood vessels are adversely affected. 
  • Retinal Detachment: This occurs when the retina detaches from the ocular structure. When the thin layer at the back of the retina detaches, it can lead to reduced fields of vision or tunnel vision.  Although this can be caused by injurious trauma, there are genetic predispositions for this condition. 
  • Inoperable Cataracts: Cataracts present as a cloudiness of the eye’s lens that affects vision. It can sometimes be surgically corrected. In instances where it cannot be repaired, low vision intervention may become necessary.
  • Retinitis pigmentosa: This includes several types of congenital eye complications which affect the retina.
  • Ocular migraine and vitreous floaters can often lead to reduced peripheral vision. Even though these causes are less serious, it is recommended to schedule a  low vision consultation if you are experiencing vision loss from these causes.
  • Brain aneurysms can cause a significant impact on vision by putting pressure on the optic nerve in the brain. Cerebral aneurysms are a serious medical condition that can lead to a wide range of visual symptoms including loss of peripheral vision. 
  • Thyroid Eye Disease: Thyroid eye disease is an autoimmune condition that can lead to multiple visual deficits including reduced visual fields. It is estimated that 6% of people with Thyroid Eye Disease will experience Optic nerve dysfunction / compressive optic neuropathy which can cause loss of peripheral vision. Other symptoms such as dry eye, double vision, and cross eye are far more common.
  • Long-term use of certain medications (such as Plaquenil, or hydroxychloroquine)
  • Pituitary adenoma/ Pituitary Tumor: When there is a larger abnormal growth in the pituitary gland it can push against the optic nerves that relay information from the eye to the brain. This can lead to gradual loss of peripheral vision as well as double vision. 
  • Choroidermia: This rare genetic condition which mainly affects males causes progressive vision loss. The condition causes cellular damage to the retina and the nearby blood vessels called the choroid. At a younger age the patient will often experience night blindness. As vision loss progresses it causes tunnel vision, or a narrowing of the field of vision, at later stages it impacts the ability to see details. 

 

Symptoms of Peripheral Vision Loss

The following are common signs or indicators of peripheral vision loss. It should be noted that there are people who experience no symptoms.

  • Tunnel vision: A tunnel vision effect is a common indicator of peripheral vision loss which causes the person to become dependent on central vision. People who experience this condition often liken the sensation to looking through a narrow tube. Peripheral vision is critical for our mobility and ability to detect movement. The loss of this function creates a unique set of challenges and difficulties. 

While it would seem that the most apparent sign would be a loss or reduction of side vision, this may not be as readily apparent as changes to the central field of vision. Loss of side vision may be harder to detect. 

    • Veil/Curtain: The sensation of having a curtain or “spider-web” off to the side of the central visual field (the region of the deficit).
    • Light shimmering: The sensation of “light shimmering” followed by a period of tunnel vision.  
  • Sensitivity to light and glare: Often presents as trails, streaks, and halos that appear around lighting.
    • Mobility: General difficulty when walking. 
    • Night-blindness: Specific difficulty when walking or driving at night or in low-light situations.
    • Tripping over objects: As noted above, mobility is frequently affected by peripheral vision loss. 
  • Redness, soreness, swelling

If you experience a loss of side vision, or are uncertain if it is deteriorating, make an appointment with our low vision optometrist for a comprehensive eye exam and to begin an early treatment plan. Depending on the findings, our low vision optometrist may recommend an evaluation with other specialists to rule out other medical complications.

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Testing

Testing for peripheral visual impairment may include:

  • Goldman field test: An older form of testing for side vision deficits. The automated perimetry test is a newer variation of this test.
  • Confrontational Visual Fields Test: A common test for side vision. The patient is asked to describe things that appear in the peripheral field of vision, while one eye is closed and the patient focuses on the doctor's finger.
  • Automated Perimetry: This is a popular test for assessing the full range of side vision.
  • Electroretinography: Depending on the cause of your visual field loss, our optometrist may perform an ERG test that looks at the electrical activity between the brain and the eye.

Interventions

Low vision optometrists are uniquely equipped to treat low vision disorders. Since the deficits of  such complications are often irreversible, treatment for such complications are focused on improving the patient's visual fields and includes the use of special visual devices along with rehabilitation therapy to learn to maximize remaining vision.There are primarily two effective ways to assist peripheral vision loss:

  1. Prisms: This intervention shifts the image from your peripheral to central vision, leading to vision. The benefit of this option is that the results are often instantaneous, effective, and relatively inexpensive. 
  2. Neuro-Optometric rehabilitation: This form of therapy trains the brain to expand the field of vision. Such a program entails learning new strategies to maximize a person's remaining vision.

Additional devices and options include the use of good lighting, assistive technologies, and optimal use of settings on hardware devices, which enable personalized modifications of brightness, lighting, contrast, and magnification.

Interventions
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Low Vision As A Cause Of Peripheral Vision

While low vision can be congenital (from birth) or secondary to optic nerve injury, degenerative eye conditions such as glaucoma are responsible for most cases of side vision loss. With proper use of vision devices such as prisms, and vision rehabilitation therapy, people with low vision deficits are able to continue with many of their daily activities and enjoy a high quality of life. If you are experiencing signs of side vision loss, contact our low vision optometrist to schedule an appointment for an eye examination.

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