Distorted vision (metamorphopsia) is characterised by the perception of straight lines as curved or wavy, and distortion of shapes in the central visual field. This symptom indicates macular involvement and must be assessed rapidly.
What is distorted vision (metamorphopsia)?
Metamorphopsia is a distortion of central vision: straight lines appear curved, faces look distorted, words on a page seem wavy. This symptom is characteristic of macular involvement, the central zone of the retina responsible for fine vision, colour and reading.
A simple self-test: look at an Amsler grid (regular grid pattern). If lines appear wavy, a corner is missing, or some squares appear blurry or deformed, consult a retina specialist urgently.
What causes distorted vision?
The main causes are:
- Wet AMD: choroidal neovessels develop beneath the macula — the most common cause in patients over 55
- Myopic neovascularisation: similar mechanism in young high myopes
- Epiretinal membrane: a thin fibrous layer that contracts and deforms the macular surface
- Macular hole: a small opening at the centre of the macula causing a central scotoma
- Central serous chorioretinopathy: accumulation of fluid beneath the retina, often in young adults under stress
Why consult urgently?
Some causes of metamorphopsia — particularly wet AMD and myopic neovascularisation — require urgent anti-VEGF intravitreal injections to stop neovascular progression. Every day of delay can mean the destruction of irreplaceable photoreceptors.
Other causes (epiretinal membrane, macular hole) require elective surgery but benefit from early diagnosis to plan optimal treatment. In all cases, new onset of distorted vision warrants urgent retinal assessment.
Further reading
Read the complete article by Dr Julien Gozlan : Amsler grid — detecting metamorphopsia at home
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