Metamorphopsia - Causes, Symptoms, Treatment

Introduction

Have you heard of people not seeing well, vision getting dull, or even losing their eyesight, mostly because of some sickness? Guess what, there is something called metamorphopsia. Big word? It's a condition where the things you see might look wiggly, misshapen, bent, or even change in size. This can happen if there is something wrong with the eye or the brain. Anyone can get this and can make their daily tasks tricky. But don’t worry, it is not a serious condition, and can be reversed after treating what is causing it. However, it is important to check with the doctor to see what is wrong and get treated early.

So, let's read this article to learn why this happens and how doctors can identify it and help people see clearly again.

What Is Metamorphopsia?

Metamorphopsia is a condition where your eyes see things differently. Here, the vision gets distorted, altered, or even misshapen. Distortion can happen to one eye or both. Here is what one may feel or what the symptoms look like:

• Straight lines may look wiggly, curved, or bent. For example, a light pole may look bent, or flat things may look bumpy.

• Objects may seem like they are in the wrong position.

• Things may look bigger (scientifically called macropsia) or smaller (micropsia).

• There may be difficulty in telling how far the things are placed.

• The letters may look twisted and cause difficulty in reading.

• It may be hard to recognize people.

• Colors may also look different.

• Sometimes things may look fuzzy (blurry vision).

Metamorphopsia may affect a large area of your vision or only the objects you look at. Sometimes, you might even see blind spots, flashing lights, and even experience pain!

What Causes Metamorphopsia?

As said before, metamorphopsia can happen due to problems with refraction, the eye, or the brain. Let's have a look at these three issues:

A. Refraction Issues: Refraction is how the light bends when it enters the eye. This light then focuses on the retina. Sometimes errors can occur when the light bends and lead to metamorphopsia. Some conditions that can cause this error are:

• Astigmatism: Here, the lens of the eye is not in proper shape.

• Anisometropia: Here, the refractive powers are different in each eye.

• New Corrective Lenses: Sometimes, wearing new glasses may also cause metamorphopsia.

B. Retinal Issues: The retina plays a special part in seeing things and is present at the back of the eyeball. It is light-sensitive. It catches the light and converts it into electrical signals. This is then sent to the brain with the help of the optic nerve. If something goes wrong with the retina, things may look wobbly or wiggly, leading to metamorphopsia. A tiny part is present in the middle of the retina called the macula. If this macula is hurt, then metamorphopsia can be severe. Conditions that can affect these parts are:

• Age-Related Macular Degeneration (AMD): As one ages, the macula gets damaged. Making it hard to see in the centre. There are two types, dry (not so bad) and wet (serious type and often causes metamorphopsia).

• Central Serous Retinopathy: Here, the fluid builds behind the retina.

• Diabetes-Related Retinopathy: This happens in diabetic people. Here, the retinal blood vessels get damaged.

• Chorioretinitis: Here, a layer called the choroid (present between the sclera and retina) gets inflamed.

• Macular Pucker: A little scar forms in the macula.

• Maular Hole: As the name suggests, a hole appears in the macula.

• Macular Edema: Here, the macula gets swollen.

• Epiretinal Membranes: Here, the fibrous layer forms on the inside of the retina.

• Retinal Bleeding: Bleeding in the retina.

• Retinal Vasculitis: Here, blood vessels of the retina get inflamed.

• Retinal Tears: Like the name suggests, there may be tears in the retina.

• Retinitis Pigmentosa: Here, the retina gets damaged and is present since birth (genetic disorder)

• Uveitis: Here, the middle part of the eye gets inflamed.

• Ocular Histoplasmosis: A fungal infection of the eye.

C. Brain Issues: The brain is a superorgan; it interprets the images that it collects from the optic nerve. Issues with the brain can mix up all the images and sometimes cause metamorphopsia. Some conditions that can cause this are:

• Alice in Wonderland Syndrome: Here, the perception of objects and even the body may look weird. Named after a storybook character!

• Medications: Hallucinogens can also cause this.

• Migraine: These are bad headaches, especially on one side, and sometimes come with an aura. Aura is like a warning sign that comes before a headache, and distorted vision can be one of the signs.

• Seizures: Here, the brain’s electrical activity gets jumbled up.

• Stroke: Here, not enough blood cannot get to the part of the brain.

• Injury: If your head or the structures of the eye get hurt, metamorphopsia can happen!

How Is Metamorphopsia Diagnosed?

So, how will a doctor tell if you are seeing things differently from others? They have some cool ways, let's see.

• Visual Acuity Test: It's an eye test, and doctors check how clearly you can see from different distances.

• Dilated Eye Examination: Doctors use special drops to make your pupil larger, so that the back of the eye can be examined.

• Amsler Grid Test: This test has a simple grid on the paper with a dot in the middle. Here, you need to focus and tell if any lines are distorted.

• M-Charts: These are special charts used to find out distortions.

• Optical Coherence Tomography (OCT): This machine is noninvasive, and detailed pictures inside the eye can be seen.

• Fluorescein Angiography: Doctors use special dye to check the blood vessels of the retina with the help of a special camera.

• Preferential Hyperacuity Perimetry: This checks how sensitive your brain is to tiny changes in vision.

How Is Metamorphopsia Cured?

It can't be cured at once. Instead, the treatment depends on what’s causing it. It's all about fixing the root of the problem! Some treatments include:

• In the case of AMD, anti-VEGF (vascular endothelial growth factor) drugs are used, which can help grow new blood vessels.

• In case of epiretinal membranes or retinal detachments, surgery is done to fix them.

• In case of wet AMD, retinal tears, or retinal hemorrhages, laser therapy is considered.

• If the problem comes from the brain, like a stroke or migraine, the treatment is directed towards that.

• In case some vision is lost, vision rehabilitation, a special training is given to function with the remaining vision present.

• Lastly, regular eye checkups are super important.

Can Metamorphopsia Be Prevented?

Well, not all cases of metamorphopsia can be prevented. But you can do a few things to lower the chances of having it, like:

• Getting regular eye checkups, like every year.

• Keeping your body healthy, such as managing health conditions like high blood pressure or diabetes.

• Reducing eye injuries by wearing safety glasses.

• Eating healthy (omega-3 fatty acids, antioxidant-rich foods), no smoking, reducing screentime, drinking lots of water, and of course, exercising.

What Is Reversal of Vision Metamorphopsia (RVM)?

Imagine, instead of seeing things blurry, wobbly, or wiggly, you see things completely upside down! Sounds like fiction, right? But, this can happen! It’s called the reversal of vision metamorphopsia, and it is super rare. This can happen if there is a problem with the brain. It can most commonly happen in the case of a vertebrobasilar stroke (a type of stroke where the back part of the brain does not get enough blood). Conditions like central nervous system tumors, seizures, multiple sclerosis, and brain trauma can also cause it. But, thankfully, it can go away on its own after a little time.

Conclusion:

Metamorphopsia is not a disease by itself, it is more like a sign that something is wrong with the brain or the eye. Having this can make everyday things like reading, writing, or watching something even harder. So, when this happens, it is better to see a doctor. Because the sooner you get help, the sooner you can protect your eyesight.

Note from iCliniq:

Metamorphopsia, though, is not an emergency; it is super important to see a doctor to find out what is causing it. An eye doctor or a brain doctor can check what is going on and help you better. Here at iCliniq, doctors are specialized, and they know what to do! You’re just one step away from getting the help you deserve.