Metamorphopsia is visual distortion where straight lines appear wavy or objects look stretched, shrunken, or irregular. It usually reflects macular pathology.
Underlying Conditions
Age‑related macular degeneration, diabetic macular oedema, epiretinal membrane, macular hole, and central serous chorioretinopathy commonly cause metamorphopsia. Fluid, scarring, or traction in the macular region disrupts normal photoreceptor alignment.
- Patients may notice letters on a page bend or faces appear distorted
- Symptoms can be monocular or more pronounced in one eye
- Onset may be gradual or relatively sudden depending on cause
- Optic nerve disease rarely causes typical metamorphopsia
Clinical Significance
New distortion is a red‑flag symptom requiring prompt macular assessment and OCT imaging. Many underlying conditions respond to injections, laser, or surgery if treated early.
- Home monitoring with an Amsler grid can track changes between visits
- Systemic control of diabetes and vascular risk factors supports macular health
- Delay in assessment may lead to permanent central vision loss
- Low‑vision aids help when some distortion persists despite treatment
