Peripheral Vision Loss (Tunnel Vision)

Evidence Based
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What is Peripheral Vision?

Peripheral vision, also known as indirect vision, is the part of your field of vision that occurs outside of your central vision. It allows you to see all around you without moving your eyes or turning your head.

Central vision, or foveal vision, is formed at the center of your eye, in the macula — the posterior part of your retina. Central vision allows you to see things directly in front of you in sharp detail. Examples include people’s faces when you’re talking to them and your phone or computer screen.

Peripheral vision helps you view objects and space outside of your central vision. It enables you to sense motion and allows you to walk, run, and drive without running into anything. If you see something “out of the corner of your eye,” you are using your peripheral vision.


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The standard person has a visual field of 170 degrees all around, and peripheral vision covers 100 degrees horizontally. 

Peripheral vision is divided into three categories:

  • Near peripheral vision borders your central vision and extends from 18 to 30 degrees of your visual field.
  • Mid-peripheral vision extends from 30 to 60 degrees of your visual field.
  • Far-peripheral vision extends from 60 to 100 degrees of your field of view.
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Peripheral Vision Loss Symptoms

Peripheral Vision Loss, also known as PVL, means that your field of vision is not as wide as it should be. You may have visual symptoms that affect your side vision, even if your central vision is acute. Moderate to severe PVL may cause it to seem like you’re looking down a narrow tube. This is often referred to as tunnel vision.

Symptoms of peripheral vision loss include:

  • Poor night vision
  • Blind spots
  • Increased or decreased light sensitivity
  • Changes in pupil size
  • Seeing halos or glare around lights
  • Soreness in your eyes
  • Migraine headaches 
  • Nausea
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Causes of Tunnel Vision

Peripheral vision loss can be caused by eye diseases, eye injuries, or other injuries and conditions that occur outside of the eye. Loss of peripheral vision may be the result of:

Glaucoma

Glaucoma is the most common cause of peripheral vision loss. Glaucoma is a disease that causes optic nerve damage, often due to elevated intraocular pressure.

Retinitis Pigmentosa

Retinitis Pigmentosa, or RP, refers to a group of eye conditions caused by genetic mutations. These conditions are inherited genetically and affect the retina, resulting in night blindness, PVL, tunnel vision, and other vision problems.

Optic Nerve Atrophy (ONA)

Optic nerve atrophy is damage or degeneration of your optic nerve due to trauma, infection, insufficient oxygen or blood supply, tumors, or other causes. ONA may cause peripheral, central, or color vision loss.

Eye Strokes

Eye strokes, also referred to as retinal artery occlusion, are caused by clots in your eye's blood vessels. The lack of blood flow to your eye can result in various vision problems, including PVL or total vision loss.

Detached Retina

Retinal detachment can be caused by injuries, retinal inflammation, posterior vitreous detachment, tumors, and some eye surgeries, causing peripheral vision loss over time.

Brain Damage 

Brain damage due to stroke, disease, or injury can cause several visual impairments, including PVL.

Optic Neuritis

Optic neuritis is the result of infections and immune diseases. It causes inflammation in the optic nerve, resulting in the loss of visual acuity, blurred vision, and blind spots.

Papilledema 

Papilledema is the swelling of your optic disc from elevated pressure in the brain. It can lead to severe visual impairment and even blindness.

Optic Nerve Compressions

Optic nerve compression happens when something puts pressure on the optic nerve. This could be a tumor or build-up of fluids. If left untreated, this can cause permanent loss of peripheral vision or even blindness.

Head Injuries

Head injuries such as concussions can cause damage to your brain or eye. This may result in any of the eye conditions listed above.

If you notice any changes in your peripheral vision, schedule a comprehensive eye exam. Catching PVL early on will increase your chances of saving your vision.

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Testing Peripheral Vision

Your eye doctor will perform a visual field test to check your peripheral vision. This is a simple, painless, and non-invasive procedure. The doctor will place a device in front of your face and cover one eye. Lights flash at different points around the bowl while you look straight ahead. You’ll be asked to push a button every time you see a light.

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Peripheral Vision Loss Treatment Options

Unfortunately, there are no simple solutions for PVL. Treatments vary depending on the causes of peripheral vision loss.

Eyeglass lenses containing prisms help to increase your field of peripheral vision. It is hoped that these lenses can help people suffering from PVL.

If you have glaucoma, or other eye problems treatments may help slow the rate of peripheral vision loss. Be sure to follow your eye doctor’s instructions regularly, and always take your medications to help prevent your eye health from deteriorating.

There are vision therapy techniques that have shown promise in helping patients regain visual field loss. These doctor-supervised programs have you undergo visual activities designed to correct vision problems.

If you have permanent peripheral vision loss, you should be referred to a low-vision specialist. They provide special optical devices that can help you regain mobility due to PVL and increase your visual skills.

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Author: Michael Bayba | UPDATED July 15, 2020
Medical reviewer: MELODY HUANG, O.D. 
Resources

Association for Research in Vision and Ophthalmology. New Glasses May Help Minimize Peripheral Vision Loss. 19 Dec. 2016, https://eye.hms.harvard.edu/news/new-glasses-may-help-minimize-peripheral-vision-loss

Peli, Eli, et al. “The Risk of Pedestrian Collisions with Peripheral Visual Field Loss.” Journal of Vision, vol. 16, no. 15, 2016, p. 5., doi:10.1167/16.15.5.

Strasburger, H., et al. “Peripheral Vision and Pattern Recognition: A Review.” Journal of Vision, vol. 11, no. 5, 2011, pp. 13–13., doi:10.1167/11.5.13.

Mcilreavy, L., et al. “Visual Field Loss, Eye Movements and Visual Search.” Journal of Vision, vol. 9, no. 8, 2010, pp. 1210–1210., doi:10.1167/9.8.1210.

Zheleznyak, Len, et al. “Optical and Neural Anisotropy in Peripheral Vision.” Journal of Vision, vol. 16, no. 5, 2016, p. 1., doi:10.1167/16.5.1.

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