Tilted vision describes the perception that the world or horizontal lines are sloping. It may indicate ocular torsion or neurological imbalance.
Potential Causes
Skew deviation, certain cranial nerve palsies, vestibular disorders, and occipital or parietal lobe lesions can create image tilt. Unequal magnification between eyes from anisometropic lenses or prismatic effects may also distort orientation.
- Patients may feel unsteady or dizzy alongside visual tilt
- Some retinal conditions with macular displacement can alter perceived level
- Head tilt compensation may be adopted unconsciously
- Acute onset often accompanies other neurological signs such as vertigo or imbalance
Evaluation
Assessment includes ocular motility, alignment, vestibular testing, and often neuro‑imaging. Management targets the underlying cause and may use prisms or rehabilitation.
- Sudden tilted vision with neurological symptoms requires emergency care
- Glasses may need adjustment to minimise optical distortion
- Persistent symptoms can benefit from neuro‑ophthalmology review
- Safety advice is important due to risk of falls
