Micropsia - Causes, Symptoms, and Treatment

Introduction:

The eye is an organ for seeing. They absorb light from the world around them and send visual information to the brain. The eyes can see about 200 degrees in all directions, including forward and sideways (peripheral vision). Each part of the eye works together to allow us to see images, movement, and depth. The eyes can see millions of different shades of color. Many conditions can affect eye function, including common vision problems such as nearsightedness or myopia, astigmatism, and eye injuries. Several diseases and disorders unrelated to the eyes can cause eye problems, such as autoimmune diseases, diabetes (high blood sugar levels), and high blood pressure.

What Is Micropsia?

Micropsia is a condition in which visual objects are perceived to be smaller than their objective size. Disturbances in areas throughout the visual system can cause Micropia. It is associated with diseases of the eye, retina, and central nervous system lesions. Micropia may be a clinical feature of migraine, stroke; temporal, parietal, or occipital lobe epilepsy; or multiple sclerosis. Occurs when ocular myasthenia is suspected after repair of a retinal detachment. In the eye, micropsia can be caused by the detachment of the retinal rod and cone cells from swelling and edema. When the density of photoreceptors decreases, the observed object is perceived as smaller than normal. It is also believed that micropsia occurs as a result of impaired accommodation (focus) of the eye caused by paralysis or fluctuations in natural function. In such cases, people have difficulty visually adjusting to (focusing on) nearby objects.

What Are the Causes of Micropsia?

Micropsia can be caused by optical factors such as wearing eyeglasses or distortion of the eye's image by corneal (transparent part of the eye) swelling. Listed below are some other factors responsible for micropsia.

• Stroke - Damage to the occipito-temporal-parietal brain regions has been found to be associated with micropsia.

• Migraine - Micropsia can occur during the aura phase of a migraine attack. This stage often precedes the onset of headaches and is often characterized by visual disturbances.

• Seizure - The most common neurological origin of micropsia is the result of temporal lobe seizures. These seizures affect the patient's entire visual field.

• Drug Use - Micropia can result from the effects of mescaline and other psychedelics.

• Psychological Factors - Psychiatric patients may have micropsia to distance themselves from conflict situations.

• Alice in Wonderland Syndrome - Alice in Wonderland Syndrome, named after Lewis Carroll's title character, is characterized by episodic episodes of visual hallucinations and distortions during which objects or body parts are enlarged. Macropsia or perceived as altered in various ways, including reduction (metamorphopsia) of the perceived size of a shape.

• Epstein-Barr Virus Infection - Micropsia can be caused by corneal swelling due to infection with Epstein-Barr virus (EBV). Therefore, it is the first symptom of EBV mononucleosis, a disease caused by Epstein-Barr virus infection.

• Retinal Edema - Micropia may result from retinal edema (fluid buildup), which causes the dislocation of receptor cells.

• Macular Degeneration - Macular degeneration usually causes micropsia due to a swelling or bulge of the macula, an oval yellow spot near the center of the retina in the human eye.

• Central Serous Chorioretinopathy - Central serous chorioretinopathy is a condition in which serous detachment of the neurosensory retina is present.

What Are the Symptoms of Micropsia?

Micropia causes the patient to perceive objects as smaller or farther away than they actually are. Most people with micropsia find that their perception does not match reality. Many people can imagine the real size of the objects and the distance between them. Patients who suffer from micropsia can commonly tell the true size and distance of objects even though they cannot perceive objects as they are.

Individuals who suffer from unilateral micropsia often complain that objects in their left or right field of view appear shrunk or compressed. They also have trouble estimating image symmetry. When drawing, patients tend to compensate for perceptual asymmetries by drawing the left or right half of an object slightly larger than the other.

How Is Micropsia Diagnosed?

The diagnosis of micropsia is made according to the condition causing it. Listed below are some methods of diagnosis for this condition:

• Electroencephalography - It can diagnose mesial temporal lobe epilepsy. Epileptiform abnormalities, including spikes and sharp waves in the brain's medial temporal lobe, can diagnose this condition, which can cause micropsia in epileptics.

• Amsler Grid Test - It can be used to diagnose macular degeneration. This test asks the patient to look at a grid and can detect distortions or white patches in the patient's central vision. A positive diagnosis of macular degeneration may cause micropsia in patients.

• Controlled Size Comparison Task - It objectively assesses whether a person has unilateral myopia. In each test, a pair of horizontally aligned circles are displayed on a computer screen, and the test taker is asked to decide which circle is larger.

• Imaging - Diagnosis is case-by-case because there are many different causes of micropsia. Computed tomography (CT) and magnetic resonance imaging (MRI) can detect lesions and areas of low density in the temporal and occipital lobes of the brain.

What Is the Treatment of Micropsia?

Treatment of micropsia depends on the diagnosis and treatment of the underlying cause. Treatment may include occlusion of one eye, and the use of a prism placed over the spectacle lens has both been shown to alleviate micropsia in suspected myasthenia gravis. Micropia due to macular degeneration can be treated by taking dietary supplements containing high doses of antioxidants and mineral supplements, reducing the risk of developing age-related macular degeneration (ARMD).

The daily dose of antioxidants and zinc are listed below:

• Five hundred milligrams of Vitamin C.

• Four hundred international units of Vitamin E.

• Fifteen milligrams of beta carotene (equivalent to 25,000 international units of Vitamin A).

• Eighty milligrams of zinc as Zinc Oxide.

• Two milligrams of copper as Copper Oxide.

• Copper supplementation has been added to AREDS Formula because of high-dose zinc.

• Lutein ten milligrams.

• Zeaxanthin two milligrams.

• Three fifty milligrams of DHA (Docosahexaenoic acid) and 650 mg EPA (Eicosapentaenoic acid).

Conclusion

Micropsia is a rare visual impairment in which the patient perceives objects as smaller than they are (decreased perceived size of shapes). Rarely, symptoms of micropsia may persist for a long time. For diagnosing micropsia, an eye doctor may do an examination to look for the cause of the distorted eye. This may include the Amsler grid test and a complete eye and brain examination. Appropriate treatment is possible if it is judged to be a symptom of macular degeneration.