Inverted vision, where the world appears upside down, is rare and usually neurological. It reflects disturbances in higher visual processing rather than eye structures.
Neurological Basis
Lesions in the brainstem, cerebellum, or cortical areas involved in spatial orientation, such as the parietal or occipital lobes, can cause inversion or rotation of the perceived image. Strokes, tumours, trauma, or multiple sclerosis are reported causes.
- Symptoms may include rotation of the visual world by 90 or 180 degrees
- Often accompanied by other neurological deficits or vertigo
- Ocular examination can be normal or show associated motility disturbances
- Functional or psychogenic phenomena are rare differential diagnoses
Clinical Urgency
Inverted vision is treated as a neurological emergency until serious causes are excluded. Immediate neuro‑imaging and specialist assessment are essential.
- Management focuses on treating the underlying brain lesion
- Some cases improve over time with rehabilitation
- Driving and hazardous activities must be avoided during symptoms
- Long‑term support may be needed if deficits persist
