Smoky vision is a description patients use for grey, hazy sight as though looking through smoke. It can signal problems with the ocular media or retina.
Underlying Causes
Vitreous haemorrhage, inflammatory cells within the vitreous, and dense cataract often create a smoky or fog-like impression. Corneal scarring or advanced macular disease may similarly reduce contrast and colour saturation.
- Sudden smoky vision with floaters can indicate bleeding from retinal vessels
- Chronic macular degeneration gives slow decline and desaturated colours
- Tobacco smoke exposure can worsen surface irritation and perceived haze
- Systemic vascular disease and diabetes are common risk factors for intra‑ocular bleeding
Assessment
Dilated examination and imaging such as ultrasound or OCT help distinguish between vitreous, lens, and retinal causes. Management may range from observation to injections, laser, or surgery.
- Emergency evaluation is needed when smoky vision follows sudden floaters or trauma
- Optimising systemic control reduces recurrence of vascular causes
- Low‑vision aids can improve function when residual haze persists
- Smoking cessation benefits both ocular and general health
