Tunnel Vision (Peripheral Vision Loss): Symptoms, Causes, Treatments

Sudden peripheral vision loss in one or both eyes is a symptom and not an eye disease itself. As the name suggests, it’s the permanent or temporary loss of side vision—the portion of your visual field that lies at the outer edges of your range of vision.

Understandably, when and if this happens, it can be an alarming experience. To avoid panic, let’s discuss what causes tunnel vision and possible treatment options, as well as prevention. And remember, if at any time your vision seems off or different, you should see your eye doctor as soon as possible.

What Does Tunnel Vision Mean?

Tunnel vision syndrome, also called peripheral vision loss (PVL) or tubular vision, is a condition in which central vision is apparent, but side vision is missing or distorted. This results in tunnel vision, meaning, in medical terms a person’s visual field is much more reduced. Essentially, it creates the illusion of looking through a narrow tube. Hence, the name “tunnel vision.”

There can be loss of peripheral vision in the left eye or the right eye or both. Regardless of whether the peripheral vision is absent in one eye or both, it may only be noticeable when one eye is closed. That’s because the brain has an exceptional ability to compensate for missing vision, and the other eye fills in the gaps.

While temporary peripheral vision loss can sometimes become permanent (more on that in a bit), it is mostly temporary. Most people don’t realize the tunnel vision effect occurs slowly over time. Therefore, it’s important to have regular eye check-ups, especially for those forty years old and up who have a higher risk of developing glaucoma.

What Does Tunnel Vision Look Like?

Whether you have peripheral vision loss in one eye or loss of peripheral vision in the left eye or right eye, your field of vision will look more or less the same. Those with tunnel vision can see well when staring straight ahead, although it looks like they are peering down a narrow tube. They cannot see peripherally and have to turn their head to see things to the side of them.

Symptoms of Tunnel Vision

The most obvious sign of tunnel vision syndrome is obscured peripheral vision in one or both eyes. Depending on the severity and whether one or both eyes are affected, it can go unnoticed.

Otherwise, signs of tunnel vision include:

• Bumping into objects or people
• Trouble navigating crowds
• Difficulty driving
• Tripping
• Falling
• Trouble seeing at night

These symptoms can be frightening if there’s sudden peripheral vision loss. However, they’re mostly gradual adaptations that happen over time, like turning the head more often or turning directly to see something head-on.

What Causes Tunnel Vision?

There isn’t a single answer to what causes sudden loss of peripheral vision. Some reasons are only identifiable by a doctor. Below are a few common causes:

#1. Glaucoma

Glaucoma is an ocular condition that affects the optic nerve. It is frequently, but not always, caused by a pressure build-up inside the eye(s). This damages the optic nerve, blocking images captured by the eye from reaching the brain, which results in progressive vision loss. In most cases, glaucoma affects both eyes but can start in one. By the time tunnel vision is apparent, glaucoma has already reached advanced stages.

#2. Stroke

Some people will experience tunnel vision eyesight after a stroke, which usually will affect both eyes. Therefore, it’s a good idea to have your peripheral vision checked if you’ve recently suffered a stroke. This is done using a visual field test at your eye doctor’s office. The good news is most people experience partial or full recovery of stroke-related visual loss over time.

#3. Migraines

Migraines cause a variety of visual disturbances called an aura. Some people see shapes and movement, while others will experience a temporary loss of peripheral vision. Auras should only last about 20-60 minutes. If migraine tunnel vision has not resolved in that time frame, or if it’s associated with other symptoms, you should consult your healthcare professional.  

When it comes to the causes of peripheral vision loss, migraines are one of the more benign reasons. However, it’s a good idea to talk to your doctor about your symptoms and have your eyes examined to ensure nothing else is going on.

#4. Retinitis Pigmentosa

Retinitis pigmentosa (RP) is a group of genetic disorders that affect the retina’s ability to respond to light, which may result in lost peripheral vision in one or both eyes. The retina has two types of cells that gather light: rods and cones.

The rods are located around the outer ring of the retina and are active in dim light. Most forms of retinitis pigmentosa affect the rods first, causing night vision and the ability to see to the side — peripheral vision — to disappear.

#5. Optic Neuritis

Optic neuritis is inflammation of the optic nerve that causes blurred, gray, dim, and tunnel vision eyesight. If optic neuritis isn’t due to an underlying condition, it may go away on its own. Sadly, the underlying cause isn’t fully understood.

However, experts believe viral infections may trigger the immune system to attack the optic nerve as if it’s a foreign invader. Loss of vision commonly reaches its maximum effect within a few days and starts to improve within 4 to 12 weeks.

#6. Retinal Detachment

Retinal detachment describes an emergency situation in which a thin layer of tissue (the retina) at the back of the eye pulls away from its normal position causing temporary loss of vision in one or both eyes. If not immediately diagnosed, and properly treated, you could go blind. This is why any abnormalities in vision should warrant immediate medical attention.

#7 Diabetic Retinopathy

Another cause of peripheral vision loss in one eye or both is diabetic retinopathy. This eye condition affects blood vessels in the retina in people who have diabetes.  It usually happens when high blood sugar levels injure the vessels in the retina, causing blood leakage and vision issues. So, if you have diabetes, it’s important to get a comprehensive dilated eye exam at least once a year.

How to Stop Tunnel Vision: Treatment Options

When tunnel vision eyes are caught in the early stages, there are multiple treatment options available, from medication to laser therapy to surgery. If not, these options become more limited as the condition worsens.

Medications

• ‍Eye drops: Prescribed eye drops can lower the pressure caused by glaucoma and prevent damage to your optic nerve(s). ‍
• Blood pressure medication: If your narrow vision is related to high blood pressure, then blood pressure medication can eliminate tunnel vision in one eye or both.‍
• Steroids: If you have optic neuritis, intravenous steroids can reduce inflammation.

Laser Treatment

• ‍Glaucoma: During laser iridotomy, a small hole is placed in the iris to create a hole for fluid to drain from the front to the back of the eye, thus reducing pressure.‍
• Diabetic retinopathy: Scatter laser therapy can be used to shrink blood vessels in your eye that are causing vision problems. ‍
• Retinal detachment: If a retinal tear or hole hasn’t progressed to detachment, your eye surgeon might suggest photocoagulation, whereby a laser beam is used to “weld” the retina to underlying tissue.

Surgery

• ‍Glaucoma surgery: Your doctor may prescribe surgery to reduce pressure and drain the fluid out of the eye.‍
• Electronic retinal implants: These introduce visual information to the retina by electrically stimulating surviving retinal neurons, which may restore vision in retinitis pigmentosa-related blindness. ‍
• Vitrectomy: Used to treat diabetic retinopathy, a vitrectomy involves removing blood that has leaked from the eye’s blood vessels.

How to Diagnose the Cause of Tunnel Vision?

Regular eye exams are the only way to diagnose the cause of tunnel vision syndrome. Remember, tunnel vision isn’t always immediately noticeable, and early detection can play a critical role in effective treatment.

There are various tests an eye doctor can perform:

• ‍Tonometry: A diagnostic test that measures pressure in your eyes.‍
• Dilated eye exam: The application of eye drops specially designed to dilate pupils, so doctors can examine the back of your eyes. ‍
• Visual field test: This measures how far your eyes see in any direction without moving and how sensitive your vision is in different parts of the visual field.‍
• Optical coherence tomography: A type of imaging that uses light waves to take pictures of your retina.

When Should I Have My Eyes Examined?

Unless you get sudden tunnel vision in one eye, you should go for annual check-ups, even if you think your vision is fine.  As your vision fades, the brain quickly adapts to accommodate vision loss, and you might think your vision is okay, even if that's not the case:

• ‍Kids: An eye specialist should check their eyes around the time they learn the alphabet, then every 1-2 years. ‍
• Adults under 40: Every 5-10 years. ‍
• Adults between 40-54: Every 2-4 years.‍
• Adults older than 55: Every 1-3 years.

You should also have your eyes checked more frequently if you:

• Take medication that has visually related side effects.
• Wear glasses or contacts.
• Have a family history of eye disease.
• Have diabetes or high blood pressure.
• Experienced a previous eye injury or have had eye surgery.
• Wear glasses and/or contacts.

Is Tunnel Vision Permanent?

If tunnel vision occurs due to a migraine, your vision loss will likely be temporary. However, some conditions, such as a stroke, may lead to permanent vision loss. In this case, treatment may not reverse the damage that’s occurred but may help prevent the condition from worsening.

Stress and Tunnel Vision

People who struggle with anxiety disorders such as PTSD or social anxiety may experience temporary peripheral vision loss along with other symptoms such as increased heart rate, muscle tension, seating, and shortness of breath.

When the human body is stressed, it produces a high amount of adrenaline that may cause a person’s field of vision to narrow into a tight circle. These symptoms can come out of nowhere and vary in intensity. If stress does affect your vision, it’s important to find healthy coping mechanisms to deal with anxiety-inducing situations.

ADHD and Tunnel Vision

Attention-deficit/hyperactivity disorder (ADHD) affects both children and adults. However, while researchers have found it’s not uncommon for people with ADHD to have certain visual impairments, these are likely because they devote much of their attention to navigating the world, which reduces their ability to focus on other things.

We might call this hyper-focus “tunnel vision”. Having said that, it’s not a medical symptom that’s a loss of peripheral vision, but rather a metaphor used to describe behavior. Talk to your healthcare provider if you think you or your child has ADHD.

How to Avoid Becoming Tunnel-Visioned

Although it’s not always possible to prevent sudden tunnel vision, maintaining good health will certainly help:

• Maintain moderate weight and cholesterol levels.
• Avoid smoking and vaping.
• Understand your family’s eye health history.
• Wear sunglasses when outdoors.
• Give your eyes a rest from screens.
• Clean your hands and contact lenses correctly to avoid infection.
• Maintain steady blood sugar levels to reduce the chances of diabetes.
• Go for regular eye check-ups.

It’s impossible to separate a tunnel vision condition from overall health. Diet and regular exercise also play a significant role. Certain vitamins and nutrients like antioxidants, omega-3, fatty acids, zinc, and phytochemicals promote strong vision and should be incorporated into your diet.

Coping with PVL Vision Loss

The tunnel vision effect or loss of side vision takes some time to get used to and can affect a person’s daily life and mental health, depending on the condition’s severity.

To help you cope, you can:

• Make sure your home is set up to allow for easy movement and to ensure you won’t bump into things.
• Receive training on how to use visual aids such as magnifying devices.
• Undergo visual rehabilitation and other treatment options.
• Seek help from counselors and other support groups.

Conclusion

A tunnel vision migraine or any loss of vision is frightening, especially if you don’t know what’s causing it. If you experience right or left peripheral vision loss or both, be sure to see your doctor right away. Some causes of tunnel vision are reversible or treatable, so the sooner you’re seen, the better. Contact us immediately if you are experiencing tunnel vision or any other visual disturbance.