Enlarged vision, or macropsia, is the perception that objects look bigger or closer than they really are. It can arise from retinal, optical, or neurological changes.
Retinal and Optical Causes
Macular disorders that thicken or stretch the retina, such as macular oedema or epiretinal membrane, can enlarge the image projected to the brain. Strong plus spectacle lenses or certain contact lens designs can also magnify what one eye sees more than the other.
- People may feel one eye sees a larger image, leading to discomfort when both eyes are open
- Post-surgical changes or retinal displacement can alter perceived size
- Some neurological conditions and migraine auras can cause temporary macropsia
- Psychological syndromes like Alice in Wonderland syndrome can exaggerate size perception
Assessment
A full eye examination with macular imaging and refraction helps identify retinal or optical causes. Neurological review and imaging may be needed if symptoms are sudden, bilateral, or associated with other brain or balance signs.
- Optical adjustments or treating macular disease may reduce size differences
- Persistent macropsia sometimes needs specialist optical solutions
- Keeping a symptom diary helps clarify duration and triggers
- Driving and safety should be considered if spatial judgement is affected
