Central vision loss affects the area used for reading, recognising faces, and detailed tasks. It is typically due to macular or optic nerve conditions.
Common Causes
Age‑related macular degeneration, diabetic macular oedema, macular holes, and hereditary macular dystrophies are major ocular causes. Optic nerve diseases such as optic neuritis or ischemic optic neuropathy can also depress central acuity and colour vision.
- People may notice blurred or missing spots in the centre of view
- Straight lines can appear wavy or distorted in macular disease
- Sudden painless central loss can indicate vascular occlusion
- Inflammatory or demyelinating conditions often affect colour and contrast
Clinical Actions
Prompt evaluation with dilated examination, OCT imaging, and visual testing is essential. Many modern treatments, including intravitreal injections and surgery, can stabilise or improve central vision if started early.
- Self‑monitoring with an Amsler grid helps detect new distortion
- Systemic risk factors such as diabetes and hypertension should be optimised
- Low‑vision aids can maximise remaining central or peripheral vision
- Urgent referral is needed for sudden central vision changes
