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metamorphopsia

Wavy distortion of central vision. Etiology: 1) exudative macular degeneration 2) retinal detachment 3) vitreous detachment 4) choroidal neovascular membrane 5) eye trauma 6) retinal inflammation 7) pathology in the visual cortex a) stroke b) seizure from mass lesion c) migraine (rare) Pathology: 1) neovascularization of the retina 2) within 1-4 weeks, neovascular membrane may bleed & preclude laser therapy 3) extension of the neovascular membrane to the central fovea 4) neovascularization may permanently scar the fovea within 8 weeks 5) pathology in the visual cortex (binocular metamorphopsia) Clinical manifestations: - wavy distortion of central vision - generally unilateral - binocular metamorphopsia much less common a) bilateral involvement of fovea b) pathology in the visual cortex Management: 1) prompt ophthalmologic referral 2) argon laser therapy to neovascularization outside the fovea 3) phototherapy sparing overlying fovea

Related

macular degeneration

General

blurry vision (decreased visual acuity, DVA)

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  2. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition 2010
  3. Distorted Vision (Metamorphopsia) University of Michigan Kellogg Eye Center http://www.kellogg.umich.edu/theeyeshaveit/disturbances/metamorphopsia.html