Can vertigo cause vision changes?

Vertigo and Vision Changes: The Connection

Yes, vertigo can cause vision changes including visual blurring, oscillopsia (illusion of visual motion), and difficulty with visual focus. 1

Types of Vision Changes Associated with Vertigo

• Visual blurring - Particularly common in stroke/ischemia-related vertigo, where patients experience vertigo with nausea, vomiting, and visual blurring 1
• Oscillopsia - The illusion of oscillation of visual surroundings, often occurring during head movements in patients with vestibular disorders 2
• Difficulty with visual focus - Problems changing focus from near to far and back, commonly seen in ocular-motor dysfunction following vestibular disorders 1
• Double vision - Can occur in certain types of vertigo, particularly those with ocular-motor involvement 1
• Visual vertigo - Dizziness provoked by visual environments with large, repetitive or moving visual patterns (e.g., supermarkets, crowds, traffic) 2, 3

Mechanism of Vision Changes in Different Vertigo Causes

Vestibular Disorders

• The vestibular system is extensively connected with visual processing areas, creating visual-vestibular interactions that can lead to vision disturbances when the vestibular system malfunctions 4
• When there's a mismatch between vestibular, visual, and somatosensory systems, patients experience both vertigo and visual disturbances 5

Specific Conditions

1. Autoimmune disorders (e.g., multiple sclerosis)

   • May present with vision problems alongside vertigo 1
   • Visual symptoms are a distinguishing feature from Ménière's disease 1

2. Stroke/Ischemia

   • Vertigo may be accompanied by visual blurring and drop attacks 1
   • Visual symptoms help differentiate vascular vertigo from peripheral causes 5

3. Vestibular Migraine

   • Features more photophobia than visual aura 1
   • Patients often experience visual motion sensitivity and difficulty with visual processing 4
   • Visual symptoms can include blurred vision and difficulty focusing 1

4. Ocular-Motor Dysfunction

   • Following vestibular injury, patients may experience:
     • Difficulty with visual activities (screen time, reading, driving)
     • Eye strain and fatigue
     • Problems with visual focus
     • Blurred or double vision
     • Vision-derived nausea 1

Clinical Significance

• Visual symptoms can help differentiate between different causes of vertigo 1
• For example:
  • Stroke/ischemia-related vertigo often includes visual blurring 1
  • Autoimmune causes may present with vision problems 1
  • Vestibular migraine typically features photophobia 1

Common Pitfalls in Assessment

• Failing to distinguish between oscillopsia (visual motion illusion) and visual vertigo (dizziness triggered by visual stimuli) 2
• Not recognizing that visual symptoms may be the key to differentiating central from peripheral causes of vertigo 1
• Overlooking that deficits in the ocular-motor system may mimic cognitive impairment functionally 1
• Missing the connection between visual dependence and increased susceptibility to visual vertigo in patients with vestibular disorders 3

Diagnostic Approach

• When patients report both vertigo and vision changes, carefully assess:
  • Timing of visual symptoms in relation to vertigo episodes 1
  • Whether visual symptoms are constant or paroxysmal 2
  • If visual symptoms are triggered by specific visual environments 3
  • Presence of other neurological symptoms that might suggest central causes 1

Visual symptoms in vertigo are not merely secondary effects but can be important diagnostic clues that help determine the underlying cause and guide appropriate treatment 1, 5.