metamorphopsia

Introduction

Wavy distortion of central vision.

Etiology

• exudative macular degeneration
• retinal detachment
• vitreous detachment
• choroidal neovascular membrane
• eye trauma
• retinal inflammation
• pathology in the visual cortex
  • stroke
  • seizure from mass lesion
  • migraine (rare)

Pathology

• neovascularization of the retina
• within 1-4 weeks, neovascular membrane may bleed & preclude laser therapy
• extension of the neovascular membrane to the central fovea
• neovascularization may permanently scar the fovea within 8 weeks
• pathology in the visual cortex (binocular metamorphopsia)

Clinical manifestations

• wavy distortion of central vision
• generally unilateral
• binocular metamorphopsia much less common
  • bilateral involvement of fovea
  • pathology in the visual cortex

Management

• prompt ophthalmologic referral
• argon laser therapy to neovascularization outside the fovea
• phototherapy sparing overlying fovea

More general terms

• blurry vision (decreased visual acuity, DVA)

Additional terms

• macular degeneration