What are Visual Disturbances?

Visual disturbances include any change in normal vision, such as blurred vision, double vision, flashing lights, blind spots, loss of vision, or difficulty focusing.

These symptoms may arise from problems affecting the eyes, optic nerves, brain, or blood vessels supplying visual pathways.

Common Causes

• Head injury
• Concussion
• Migraine
• Stroke
• Optic nerve disorders
• Retinal disease
• Brain tumors
• Multiple sclerosis 

How is it Diagnosed?

Assessment includes:

• Vision testing
• Eye examination
• Neurological evaluation
• Symptom history 

Investigations

• MRI Brain
• CT Brain
• Visual field testing
• Fundus examination
• Optical coherence tomography (OCT) 

Treatment Options

Treatment depends on the underlying cause and may involve:

• Medications
• Vision therapy
• Neurological treatment
• Surgical intervention 

When Should You Consult a Doctor?

Seek evaluation if visual symptoms are persistent, recurrent, or sudden in onset.

Red Flags

• Sudden vision loss
• Double vision
• Vision changes with weakness
• Severe headache
• Stroke symptoms 

FAQs

Can a concussion affect vision?

Yes. Visual disturbances are common after concussion.

Is blurred vision always an eye problem?

No. Neurological conditions can also cause visual symptoms.

When is sudden vision loss an emergency?

Immediately, as it may indicate stroke or retinal damage.

When to Consult:

Prompt evaluation of visual symptoms can help protect vision and identify serious neurological conditions early.

What is a Stroke?

A stroke (cerebrovascular accident) occurs when blood flow to a region of the brain is suddenly interrupted, either by arterial occlusion (ischemic stroke — approximately 85% of cases) or by rupture of a blood vessel (hemorrhagic stroke — approximately 15% of cases). Deprivation of oxygen and glucose leads to neuronal death; it is estimated that approximately 1.9 million neurons die per minute during an untreated ischemic stroke.

"Time is brain" — early reperfusion therapy with intravenous thrombolysis (tPA) within 4.5 hours and mechanical thrombectomy within 24 hours in selected patients significantly improves functional outcomes.

Powers WJ, et al. 2019 AHA/ASA Guidelines for the Early Management of Patients with Acute Ischemic Stroke. Stroke. 2019;50(12):e344–e418. doi:10.1161/STR.0000000000000211

The BE-FAST Acronym (Updated from FAST)

Recent evidence supports the expanded BE-FAST acronym to identify additional stroke symptoms often missed by FAST alone:

• B — Balance: sudden difficulty with balance or coordination
• E — Eyes: sudden vision change, double vision, or loss of vision
• F — Face: facial drooping (ask patient to smile)
• A — Arms: arm or leg weakness (ask patient to raise both arms)
• S — Speech: slurred, confused, or no speech
• T — Time: time to call emergency services immediately

Transient Ischemic Attack (TIA)

Stroke symptoms that resolve completely within 24 hours (and typically within 1 hour) may represent a Transient Ischemic Attack (TIA). TIA is NOT benign — it carries a high short-term risk of completed stroke (up to 10–15% within 90 days, with highest risk in the first 48 hours). All TIA patients require urgent evaluation and secondary prevention.

Johnston SC, et al. Transient ischemic attack: part 1. Diagnosis and evaluation. N Engl J Med. 2002;347(21):1714–1721. doi:10.1056/NEJMcp020190

Treatment

• IV alteplase (tPA): eligible patients within 4.5 hours of symptom onset
• Mechanical thrombectomy: eligible patients within 6–24 hours depending on imaging criteria
• Blood pressure management per guidelines
• Antiplatelet therapy (aspirin / dual antiplatelet in TIA)
• Anticoagulation (in cardioembolic stroke/AF)
• Stroke unit admission
• Rehabilitation: physiotherapy, speech therapy, occupational therapy