What are the Causes of Tunnel Vision, Its Symptoms & Treatment

Tunnel vision, as the name suggests, is a health condition where your field of vision gets narrowed down to a level where you are no longer able to see sideways without physically turning your head sideways. The condition is also known as peripheral vision loss or PVL. If you suffer from tunnel vision, you are only able to see things that are right in front of you. Loss of peripheral or side vision creates many types of challenges in your day to day life, and it often also impacts your ability to get around, your overall orientation, and how well you are able to see at night. Tunnel vision can also prevent you from driving safely.

What is Tunnel Vision?

Tunnel vision, or peripheral vision loss, is a condition where you lose the ability to sideways. You are only able to see things that are right in front of you, and you can only see the things that are on the sides by turning your head sideways.

Also referred to as tunnel vision syndrome, this inability to see things from the outer edges of the field of vision can either be a temporary condition or it might be a permanent problem.

Losing your side vision can create many types of challenges in your daily life, including having trouble with your overall orientation, how you move around, and even how well you are able to drive at night. Simple activities such as reading a book may also be affected.(1, 2, 3)

What Are The Causes Of Tunnel Vision?

There are many causes of tunnel vision, and this condition can also be caused as a result of other eye conditions or health conditions. If you are experiencing a loss of side vision, then it is important to seek treatment immediately in order to prevent the condition from becoming permanent. Sometimes a delay in treatment can make it difficult to restore lost vision. Early treatment for tunnel vision helps prevent any further vision loss and also safeguards your eye from other conditions.

As mentioned, there are many underlying health conditions that may cause tunnel vision. For example, migraines can lead to a temporary loss of peripheral vision, while other health conditions can increase the risk of developing permanent tunnel vision. You may either experience this loss of side vision for some time, with only a small part of the side vision getting affected in the beginning.

Here are some of the major causes of tunnel vision:

Glaucoma

Glaucoma is one of the most common conditions of the eye that causes tunnel vision. Glaucoma is characterized by increased pressure in the eye due to the accumulation of fluid. It has a direct impact on the peripheral vision, and if left untreated, it can go on to affect the optic nerve and lead to irreversible blindness.(4)

When the optic nerve gets damaged, blind spots start appearing in the field of vision of people who are suffering from tunnel vision.

If you experience any of the following symptoms, then you should immediately get your eyes checked:

  • Tunnel vision (not being able to see sideways without turning your head)
  • Blurriness
  • Cloudiness of vision
  • Seeing halos around lights
  • Nausea and/or vomiting
  • Severe pain in the eye

All these might indicate that the pressure is increased inside the eye, and early diagnosis of glaucoma can present the permanent loss of vision.

Cataracts

A cataract is a common condition affecting the eye that happens due to the clumping of the protein present in the eye. It eventually leads to the clouding of the lens, thus affecting your field of vision. In many people, a thin white film is often visible over the eyeball.

A particular type of cataract that forms in the center of the lens (known as a nuclear cataract) can begin damaging the lens from the edges, causing peripheral vision loss. Common symptoms of cataracts include:

  • Seeing two images of a single thing
  • Blurry vision
  • Increased sensitivity to light
  • Problems seeing clearly at night
  • Seeing colored objects as being yellowish or faded

There are many types of cataract surgery options available for the treatment of cataracts. At the same time, there are also many home remedies and natural ways of preventing the formation of cataracts. Older adults are more at risk of developing cataracts.(5)

Retinitis Pigmentosa

This is a genetic condition that gradually leads to tunnel vision. This is a progressive eye disease that targets and damages the light-sensitive cells in the retina known as the rods and cones. The rods and cones of the retina are responsible for collecting all visual information that gets transmitted to the brain. The resulting vision loss from retinitis pigmentosa typically begins with the loss of peripheral vision.(6)

It can also affect a person’s night vision and even the central vision because the disease causes deterioration of the retina. There is no cure for retinitis pigmentosa, and neither have experts been able to identify a definite cause of this condition. It is a very rare condition that is believed to be linked to some form of genetic malfunctioning. However, if it is diagnosed at an early stage, you can still come up with a treatment plan that prevents total vision loss.(7)

Retinal Detachment

Retinal detachment means the detachment of the retina from the back of the eye. This is an extremely serious condition that requires immediate medical attention, or else it can lead to a permanent loss of vision.

The visual symptoms of retinal detachment cause floaters and flashes to appear in your peripheral vision, limiting your field of vision at times and gradually leading towards the total loss of peripheral vision.

Here are the common symptoms of retinal detachment:

  • The sudden appearance of many floaters (floaters are small specks that appear to be drifting through your field of vision)
  • Blurred vision
  • Flashes of light in one or both eyes
  • A gradual reduction in peripheral vision
  • Curtain-like shadow over the visual field

Retinal detachment should be treated as a vision-threatening emergency, and you should immediately head to your nearest emergency room or call an ambulance.

Ocular Migraine

Ocular migraines are slightly different from regular migraines. Ocular migraines are a rare condition and are characterized by a temporary loss of vision, tunnel vision, or temporary blindness in just one eye. Ocular migraines are usually caused by a decrease in blood flow or spasming of the blood vessels behind the eye or in the retina.(8)

Most ocular migraines are painless, though people who regularly suffer from ocular migraines have reported experiencing a type of scintillating shimmer in their field of vision.

Some people even experience halos appearing around objects along with loss of peripheral vision.(9)

These migraines are more or less harmless, and the symptoms also tend to subside on their own within a couple of minutes.

Even people who suffer from regular migraine headaches experience changes in their vision. According to the American Migraine Foundation, nearly 25 to 30 percent of all people with migraine experience some type of visual changes when they have migraine with an aura. The symptoms may also include temporary loss of peripheral vision.(10)

Scotoma

A scotoma is a blind spot that occurs in the center of a person’s field of vision. It can appear in many different ways:

  • It may look like a gray or black spot
  • It may appear to be a blurred smudge
  • The view may appear to be distorted when the person looks straight ahead
  • Scotomas usually begin as a minor nuisance in a person’s vision, but over time they may grow to become several blind spots that start to block a person’s field of vision.(11)
  • Scotomas that develop in the periphery in a person’s vision may lead to peripheral vision loss.

Some of the known causes of a scotoma include:

  • Glaucoma
  • Inflammation
  • Macular degeneration
  • Eye infections
  • Tumors
  • Traumatic brain injuries
  • Stroke
  • Other eye conditions

Stroke

A stroke can also cause temporary or permanent loss of vision on just one side of each eye. This is because a stroke can cause severe damage to only one side of the brain. This is a type of neurological vision loss since your eyes are still perfectly fine and in working order, but the brain is unable to process what you are seeing. A stroke may also cause a scotoma.

Concussion

A concussion may disrupt the blood flow to the brain, depriving the brain of not just oxygen, but many essential nutrients as well for a certain time. This may be followed by dizziness, confusion, and different types of visual disturbances, including loss of peripheral vision.

Choroideremia

Choroideremia is a very rare hereditary condition that is characterized by a progressive loss of vision. The disease primarily affects males, and the first symptom of choroideremia is usually a loss of night vision or night blindness. This is followed by a narrowing of the field of vision, leading to loss of peripheral vision. This also decreases the ability to see details clearly.(12)

The vision impairment in choroideremia tends to worsen over time, but the pattern in which the condition progresses varies from person to person. Nevertheless, everyone who has this condition will eventually go on to develop total blindness, usually by late adulthood.

Genetic mutations are believed to be the primary cause of choroideremia.(13)

Diabetic Retinopathy

This is a condition that occurs if you have diabetes and, due to high blood sugar, end up experiencing damage to your retina. High blood sugar can cause inflammation or restrict the blood vessels in the eyes, causing tunnel vision.

Temporary and Permanent Tunnel Vision

Loss of peripheral vision can be of two types – temporary or permanent. It depends on the underlying cause of the loss of sight.

Some of the common causes of permanent tunnel vision are:

  • Glaucoma
  • Scotoma
  • Stroke
  • Diabetic retinopathy
  • Retinitis pigmentosa
  • Temporary tunnel vision is more commonly observed with migraines.

People also experience a different range of sensitivity with tunnel vision. For example, certain conditions will start the distortion of sight from the outermost angles and then work inwards as the condition progresses.

What are the Symptoms of Tunnel Vision?

You are likely to notice that you have tunnel vision once you are no longer able to see 40 degrees or more from the sides of your eyes. If you are not able to see beyond 20 degrees of the vision field, then you are considered to be medically blind.

You will notice the symptoms of tunnel vision either gradually or all of a sudden, depending on the underlying cause. Some common symptoms of tunnel vision include:

  • Falling
  • Bumping into objects
  • Difficulty in navigating through crowded places, for example at a shopping center
  • Night blindness, or being unable to see clearly in the dark
  • Having trouble driving at night, and even during the day as the condition progresses

You may have tunnel vision either in one eye or in both your eyes. If you notice these symptoms, then it is essential to discuss your condition with an ophthalmologist so that your doctor can determine whether you should still be driving or engaging in any other high-risk activities.

Treatment of Tunnel Vision

In some cases of peripheral vision loss, the side vision may not be restored, and the condition might be permanent. This is why it is so vital that you consult a doctor as soon as you start noticing the symptoms mentioned above. The earlier your condition is diagnosed, the higher are the chances of saving your vision.

Your doctor may suggest some lifestyle changes if you have tunnel vision, including being trained on how to visually look at the world around you using the field of vision you now have.

Some research also suggests that using glasses that feature a prism may help augment the side vision if you have peripheral vision loss.(14)

The treatments for tunnel vision depends on the underlying condition that is causing vision loss. The primary focus of the treatments is to slow down vision loss.

For example, if your tunnel vision is being caused by glaucoma, then you might be told to use eye drops or another medication to prevent the condition from worsening. Some cases may require surgical intervention to prevent glaucoma from worsening.

In case of a stroke, it might not be possible to treat the tunnel vision, but visual screening techniques and using glasses with prisms may help you move around better.

Conclusion

Tunnel vision leads to the loss of peripheral vision, and it is likely to affect your day to day activities significantly if the condition tends to worsen over time. Finding resources that will help you navigate and keeping a positive outlook will go a long way in helping you cope with this type of vision loss.

Some other ways in which you can manage tunnel vision include:

  • Discuss with your doctor about ways to treat and adapt your lifestyle with the condition.
  • Let your friends and family know about your condition so that they are there to support you.
  • Practice self-care
  • Eat a healthy diet and exercise regularly to lower your stress levels and boost your physical and mental health
  • Add extra light to any dimly lit rooms
  • Modify the rooms in your home in such a manner that you are able to navigate easily and prevent any falls.
  • Discuss the safety of driving with your doctor.

Remember that there are many conditions that cause tunnel vision, and it is crucial to find out what condition is causing you to lose your peripheral vision. If you ignore your symptoms, then you are only going to experience more vision loss as time progresses. So see your doctor and make it a habit to get regular eye check-ups done to prevent any eye-related problems.

References:

  1. Kotecha, A., Chopra, R., Fahy, R.T. and Rubin, G.S., 2013. Dual tasking and balance in those with central and peripheral vision loss. Investigative ophthalmology & visual science, 54(8), pp.5408-5415.
  2. Harvey, H. and Walker, R., 2014. Reading with peripheral vision: A comparison of reading dynamic scrolling and static text with a simulated central scotoma. Vision Research, 98, pp.54-60.
  3. Pundlik, S., Tomasi, M. and Luo, G., 2015. Evaluation of a portable collision warning device for patients with peripheral vision loss in an obstacle course. Investigative ophthalmology & visual science, 56(4), pp.2571-2579.
  4. Evans, K., Law, S.K., Walt, J., Buchholz, P. and Hansen, J., 2009. The quality of life impact of peripheral versus central vision loss with a focus on glaucoma versus age-related macular degeneration. Clinical Ophthalmology (Auckland, NZ), 3, p.433.
  5. Eichenbaum, J.W., 2012. Geriatric vision loss due to cataracts, macular degeneration, and glaucoma. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 79(2), pp.276-294.
  6. Hamel, C., 2006. Retinitis pigmentosa. Orphanet journal of rare diseases, 1(1), p.40.
  7. Wells, J., Wroblewski, J., Keen, J., Inglehearn, C., Jubb, C., Eckstein, A., Jay, M., Arden, G., Bhattacharya, S., Fitzke, F. and Bird, A., 1993. Mutations in the human retinal degeneration slow (RDS) gene can cause either retinitis pigmentosa or macular dystrophy. Nature genetics, 3(3), pp.213-218.
  8. Wolter, J.R. and Burchfield, W.J., 1971. Ocular migraine in a young man resulting in unilateral transient blindness and retinal edema. Journal of Pediatric Ophthalmology and Strabismus, 8(3), pp.173-176.
  9. McKendrick, A.M., Vingrys, A.J., Badcock, D.R. and Heywood, J.T., 2000. Visual field losses in subjects with migraine headaches. Investigative ophthalmology & visual science, 41(5), pp.1239-1247.
  10. Americanmigrainefoundation.org. (2020). [online] Available at: https://americanmigrainefoundation.org/resource-library/visual-disturbances-related-to-migraine-or-not/ [Accessed 8 Mar. 2020].
  11. Jung, K.I., Park, H.Y.L. and Park, C.K., 2012. Characteristics of optic disc morphology in glaucoma patients with parafoveal scotoma compared to peripheral scotoma. Investigative ophthalmology & visual science, 53(8), pp.4813-4820.
  12. MacDonald, I.M., Binczyk, N., Radziwon, A. and Dimopoulos, I., 2020. Choroideremia. In Hereditary Chorioretinal Disorders (pp. 99-106). Springer, Singapore.
  13. Sankila, E.M., Tolvanen, R., van den Hurk, J.A., Cremers, F.P. and de la Chapelle, A., 1992. Aberrant splicing of the CHM gene is a significant cause of choroideremia. Nature genetics, 1(2), pp.109-113.
  14. Peli, E., Apfelbaum, H., Berson, E.L. and Goldstein, R.B., 2016. The risk of pedestrian collisions with peripheral visual field loss. Journal of vision, 16(15), pp.5-5.

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