What Causes of Peripheral Vision Loss?

What Causes Loss of Peripheral Vision

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Peripheral vision loss, often known as tunnel vision, can be caused by a variety of medical diseases, including stroke, glaucoma, and diabetic eye disease.

What is the peripheral vision?

Peripheral vision refers to the ability to see things that are not directly in front of you. When you see things out of the corner of your eye, you’re using peripheral vision. Rod nerve cells, which are found outside of the macula (the center of the retina), aid peripheral vision. 

Peripheral vision is crucial because it allows you to perceive objects in your immediate surroundings without turning your head or moving your eyes. You use this for a variety of things, including driving and sports. 

PVL (peripheral vision loss), often known as tunnel vision, is the loss of peripheral vision. PVL patients can see what is directly in front of them, but their side vision may be impaired. 

PVL is also known as tunnel vision since it makes you feel like you’re in a tiny tunnel. The objects above, below, and around you are black, but everything in front of you is visible.

Peripheral Vision Loss causes

Depending on the reason, PVL might be permanent or transitory. When you get migraines, you may experience temporary PVL. PVL can become permanent due to a variety of factors, including: 

  • Diabetic retinopathy is an eye disease that causes Peripheral vision loss and blindness in diabetics. Vision loss can result from damaged blood vessels in the retina. 
  • Glaucoma refers to a set of eye diseases that affect the optic nerve, resulting in vision loss and possibly blindness. The optic nerve is in charge of delivering impulses to the brain in order to create images. 
  • Retinitis pigmentosa is a set of hereditary diseases that cause your retina to break down and lose cells. This disorder alters the way your retina responds to light, making it more difficult to see. 
  • A typical symptom of a stroke is difficulty seeing in one or both eyes. After a stroke, a person may lose a piece of their peripheral vision. Any vision loss caused by a stroke usually affects both eyes.

Migraine induced vision loss

For a brief period of time — less than an hour — an ocular migraine can induce vision loss or blindness in one eye. This might occur before or after a migraine headache. An Aura, which might include flashing lights and blind areas, can accompany migraine symptoms on a regular basis. However, these symptoms frequently affect both eyes.

Ocular migraines are often mistaken for retinal detachments due to their symptoms of flashes of lights and spots in the vision. Since they are usually for a short period of time and often followed by a migraine headache they are usually easy to differentiate.

Frequent migraines can be a symptom of other health issues and should be followed up with by your doctor.

Diabetic retinopathy and peripheral vision loss

Diabetes can harm the retina’s tiny blood vessels, which supply it. Blood vessels can become leaky as a result of the injury, similar to a water hose with holes in it. Non-proliferative retinopathy is the name for this condition. Fluid escapes from blood vessels into the retinal tissue, potentially causing vision issues. The retina thickens, as a result, resulting in blurred vision. 

Blood arteries injured by hyperglycemia (high blood sugar, or high blood glucose) close in another process, triggering a chain of events. When retinal tissue is starved for oxygen it grows, resulting in the formation of new blood vessels on the retina’s surface. This is called neovascularization.  Proliferative retinopathy is a condition in which new blood vessels grow in the retina. 

These newly formed blood vessels are fragile and prone to rupturing and bleeding. This causes scar tissue to form on the back wall of the eye, stretching the retina and finally detaching it from the back wall. Retinal detachment is the medical term for this disorder, which can occur suddenly or gradually over time.

Peripheral vision loss due to glaucoma

Glaucoma can develop for no apparent reason, yet it is influenced by a variety of variables. Intraocular eye pressure is the most essential of these. Your eyes are nourished by a fluid known as aqueous humor. This liquid travels to the front of the eye through the pupil. The fluid exits a healthy eye through a drainage canal called the trabecular meshwork between the iris and the cornea. 

One form of Glaucoma causes tiny deposits of pigment that obstruct the drainage canals. Because the fluid has nowhere to go, it accumulates in the eye. This causes the eye pressure to increase.   This increased eye pressure can eventually damage the optic nerve, resulting in glaucoma. 

In some cases, the aqueous humor is overproduced inside the eye, and even though the drainage system may not be clogged or blocked but it can’t drain the fluid fast enough as to not cause the pressure of the eye to rise. The pressure created then causes a choking off of the blood flow to the nerves and of the nerves themselves. This causes the atrophy of the nerves and a decrease in peripheral vision.

Vision loss from stroke

Following a stroke, up to two-thirds of persons report vision changes. 

  • According to Stroke.org, up to 66 percent of all stroke survivors will have vision changes as a result of the incident. 
  • After a stroke, vision loss, also known as visual field loss, is frequent. 
  • Stroke victims are thought to have a 20 percent chance of developing a lifelong visual field loss. Hemianopia, Quadrantanopia, and Scotoma are examples of particular forms of visual field loss. 
  • A sudden loss of vision in one eye could indicate the onset of a stroke. 
  • A person may have already had a Transient Ischemic Attack, or TIA, before suffering from a stroke. A TIA can cause Peripheral vision loss on either the left or right side of the visual field, with visual field deficits in both eyes being the most common form of visual field deficit following a stroke.

Tunnel vision from Retinitis Pigmentosa

The loss of night vision is frequently the first sign of retinitis pigmentosa, which appears in childhood. Navigation in low light can be difficult if you have night vision issues. Blind patches form in the side (peripheral) vision as the disease progresses. Tunnel vision develops when these blind patches combine over time. The condition affects central vision, which is required for precise tasks like reading, driving, and recognizing faces, over years or decades. Many persons with retinitis pigmentosa become legally blind as adults. 

Vision loss is most commonly noticed as a child or in early adulthood. The condition worsens over time. Vision loss can become severe after a few years. 

The type of retinal cell that is damaged determines the symptoms. The loss of vision in both eyes is common. 

It should be mentioned that RP is a condition that progresses slowly over time and that the majority of sufferers never go completely blind. In fact, many patients with RP are regarded as “legally blind” simply because their fields of view are very constricted (poor peripheral vision). Some people still have good central visual acuity. 

Symptoms may include the following: 

  • Blindness at night (the most common symptom) 
  • The eyes take longer to adapt to dim illumination or to switch from bright sunlight to indoor lighting. 
  • In foggy or wet conditions, it’s difficult to see. 
  • The term “tunnel vision” refers to a loss of peripheral vision or a narrowing of the visual field. 
  • Colors, especially blue, are difficult to see. 
  • Visual impairment, whether partial or complete, is usually progressive. 
  • Lack of vision causes clumsiness, especially in tight situations like doorways. 

Rp is an inherited disease and is passed from one generation to the next. There are no known ways to prevent RP from developing after it has been inherited. If you have RP or a family history of the disorder, you should consult a genetic counselor before starting a family.

Artery and vein occlusions

Blood is carried throughout your body, including your eyes, through arteries and veins. One main artery and one main vein run through the retina of the eye. Branch retinal vein occlusion occurs when the branches of the retinal vein become occluded (BRVO). 

Blood and fluid leak out into the retina when a vein is occluded. This fluid might cause the macula to thicken, compromising your central vision. Without blood circulation, nerve cells in the eye can die and eyesight can deteriorate. This also can cause peripheral vision loss symptoms. Depending on how soon it is caught and treated by your eye doctor, lost vision may be permanent vision loss or temporary peripheral vision loss.

Branch retinal artery occlusions can cause sudden peripheral vision loss. Artery and vein occlusions are usually due to underlying medical conditions.

Retinal detachments

A retinal detachment is a medical emergency in which a thin layer of tissue at the back of the eye (the retina) is pulled away from its normal location. This condition requires immediate medical attention.

The retinal cells are separated from the layer of blood vessels that gives oxygen and sustenance by a retinal detachment. The longer you wait to treat a retinal detachment, the more likely you are to lose vision in the affected eye permanently.

Symptoms of retinal detachment

Retinal detachment itself is painless. But warning signs almost always appear before it occurs or has advanced, such as:

  • The sudden appearance of many floaters — tiny specks that seem to drift through your field of vision
  • Flashes of light in one or both eyes (photopsia)
  • Blurred vision
  • Gradually reduced side (peripheral) vision
  • A curtain-like shadow over your visual field

Diagnosis of peripheral vision loss

There are obviously many causes of peripheral vision loss problems. Regular visits to your eye doctor are important to prevent peripheral vision loss. Diagnosing eye conditions in the early stages is key to maintaining good peripheral sight. Dilated eye exams, visual field tests, and cardiovascular tests all help to determine the underlying causes of peripheral vision loss.

Many conditions that cause vision can be diagnosed with a visit to your primary care doctor. A healthy diet and lifestyles are so important for not only your body but your eye health also. 

Treatment of the loss of peripheral vision

Since there can be so many underlying causes of peripheral vision loss there are many different treatment options. Some may be to treat an underlying medical condition like diabetes or cardiovascular disease. Others may require immediate retinal surgery as in the case of retinal detachment. Glaucoma can be a lifelong ailment that will require drops every day for the rest of your life. However new surgeries are becoming better and a long-term solution. Even though the surgeries may be expensive, the long-term cost of daily medications adds up. Being able to have a procedure and avoid having to do the eye drops daily is quite appealing to many. 

Lifestyle changes for higher-risk people can be one of the best treatment options for visual problems. Diet and exercise reduce blood pressure, can lower blood sugars, all of which make for healthier eyes. 

Low vision options for peripheral vision loss

If you happen to be one of the unfortunate people to have permanent peripheral vision loss. There are many devices to help keep you functioning and independent. Glasses with a prism can help with side vision problems. Reverse telescopes are used for tunnel vision in the case of glaucoma and RP. These are just a couple of examples. Be sure to contact one of our low vision specialists to help find the right solutions for you.

About the Author:
Dr. Shaun Larsen

Dr. Shaun Larsen

Dr. Shaun Larsen is an optometrist who specializes in low vision services and enhancing vision with contact lenses. He has a passion for making people's lives better by helping them see well enough to read, write, or drive again. He always keeps up with the latest technology so he can help people regain their independence.

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