Central Vision Loss: Overview and More

Central vision loss refers to either the sudden or gradual loss of central vision. It involves losing the details in a person’s vision and instead seeing one or more dark or blurry spots in their field of vision. These spots may grow in size or multiply over time.

This article will discuss central vision loss, its symptoms, diagnosis, and treatment.

What Is Central Vision Loss?

In order to see, light must pass through the pupil, which is the small black dot in the center of our eyes. It is then translated into electrical signals by the retina, which is a sheet of cells located in the back of the eye. The optic nerves carry this information to the brain, which processes it.

Central vision loss often happens because there is an interruption in this process, usually due to damage to the macula, which is at the center of the retina. Central vision loss can be the result of an injury or other health conditions.

Symptoms 

Central vision loss often starts with a single small dark spot in the center of one’s vision that enlarges over time. But it doesn’t always occur like that for everyone.

Other symptoms can include:

• Vision appearing wavy or distorted
• One or more “blank” spots in the field of vision
• Greying, dulling, or bleaching of colors perceived in vision

Diagnosis

Central vision loss is usually diagnosed by a healthcare professional who specializes in eyes, such as an optometrist or ophthalmologist. They will examine the person’s eyes to determine if there are problems with their central vision.

 Some of these tests may include:

• Light examination: Shining a light into the patient’s eyes to check for biological abnormalities, such as dark spots, swelling, clots, or cataracts
• Pupil dilation: Dilation of the patient’s pupils for a better look inside the eye or eyes
• Amsler grid test: During this test, the patient is asked to look at graph paper with a dot in the center, while focusing on the dot. They will first use one eye while covering the other with their hand or a piece of paper, and then switch to the other eye. If the grids in the graph paper appear wavy to the patient, or they see more black dots than the one in the center, they are likely experiencing central vision loss.
• Neurological examination: Tests the function of the eyes and brain

Treatment

The treatment for central vision loss can vary and often depends on the underlying cause.

Some of these conditions can include:

• Wet age-related macular degeneration (AMD) is a condition that causes the macula to degenerate due to new blood vessels forming and putting pressure on it. It can be treated by injecting a medication into the eye impacted by the AMD, called anti-VEGF (vascular endothelial growth factor). This medication stops the blood vessels from growing and slows down the loss of vision.
• Macular edema is a buildup of fluid around the macula, which can be treated by injecting steroids into the impacted eye to reduce inflammation. 
• Retinopathy is the growth and inflammation of blood vessels around the retina, usually related to diabetes. It can be treated by better managing blood-sugar levels.

Surgery may also be a treatment option. There are surgeries being piloted during which the natural lens on the eye is removed and replaced with an artificial telescopic lens. Some of these procedures are still in the experimental stages and aren’t broadly available yet, while others have been available for some time.

For patients with conditions like AMD, another treatment for central vision loss can include wearing special glasses, which can help the patient see better.

Generally speaking, treatment will depend on the reason for the central vision loss and may require multiple strategies.

Prognosis

A person’s prognosis for central vision loss will depend on their individual situation, including the health condition causing the vision loss.

Some people with central vision loss may only experience a minor loss in their central vision that can be restored through certain medical interventions or surgeries. In some cases, central vision loss can correct itself over time.

However, that may not often be the case for many patients. Most patients will likely require some kind of medical intervention to either slow, stop, or reverse the central vision loss.

There is also a possibility that the patient may eventually experience significant or total loss of vision. That will not be true in many cases, though.

Some people with central vision loss may be able to work and function at or close to what their capacity was before they developed the vision loss. Others will develop more severe cases and live with more restrictions. In these cases, patients may have to learn to adopt extensive adaptations in order to better cope with their situation.

A Word From Verywell

If you suspect you are experiencing central vision loss, consult with your healthcare provider or an eye specialist. They may be able to offer you treatments that can potentially restore part or all of your central vision, or slow down the rate of the vision loss.

If it’s not possible to reverse the central vision loss or slow down its pace, other treatment plans—including developing healthy coping strategies and making lifestyle adaptations—are available to help you better manage the condition.