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Dizziness and Blurred Vision: Causes, Symptoms, and Treatment
Blurred vision and dizziness can occur together and can be scary when experienced for the first time. The vestibular and visual systems are closely related and work together to maintain orientation and stability. The vestibulo-ocular reflex (VOR) allows your eyes to remain fixed on a target by moving in the opposite direction from your head movement, so a stable image remains on the retina. If either of the systems is disrupted, you may experience blurry vision, dizziness, fatigue, and/or motion sickness.
Eye strain, prolonged screen time, or a new prescription may temporarily cause these symptoms; however, blurred vision and dizziness can also be symptoms of a more serious medical issue, and you should seek urgent care. A doctor will identify the cause through a comprehensive eye exam and/or send you for an evaluation of other systemic conditions.
We will discuss the association between blurred vision and dizziness, the potential cause, both serious and routine, and provide information on how to best treat your symptoms. Keep in mind, it’s important to see a doctor when your symptoms persist or worsen.
What Is Dizziness and Blurred Vision?
Blurred vision and dizziness are two separate symptoms but may occur together due to medical conditions of the eyes, brain, inner ear, or cardiovascular system. Vision is a function of the eyes and brain, but dizziness involves balance, orientation, and the way the brain processes sensory information. When experienced together, the condition could be serious and should be evaluated by a doctor.
Dizziness is the feeling of being lightheaded or as if the world around you is spinning (vertigo). It is a symptom of an inner ear condition, low blood pressure, dehydration or a neurological condition. There are three types of dizziness: vertigo, lightheadedness, and disequilibrium. Vertigo is the feeling that either you or your surroundings are spinning when they are not. It is often caused by an inner ear problem like vestibular neuritis or Ménière’s disease. Lightheadedness, also called presyncope, is feeling faint or lightheaded and can be caused by low blood pressure, dehydration, anemia, or changes in blood flow to the brain.
Lastly, disequilibrium is the feeling of imbalance or unsteadiness when walking. Disequilibrium can be caused by inner ear problems, muscle weakness, nerve problems, or a neurological disease like Parkinson’s. Dizziness and problems with balance are often interchanged, but they are different. Dizziness refers to the sensation that your environment is spinning whereas an issue with balance means you are physically unable to maintain your posture and coordination.
Blurred vision is a condition where objects appear out of focus, hazy, or it is difficult to see details. Blurred vision is a symptom of an ocular condition like refractive error, cataracts, or glaucoma, or a systemic condition like diabetes or multiple sclerosis. These conditions alter the light that enters the eye, so it does not focus at the correct spot on the retina.
Common Causes of Dizziness and Blurred Vision
Dizziness and blurred vision can result from an ocular, vestibular, neurological, or cardiovascular disorder.
Ocular Disorders
Ocular reasons for the symptoms may be due to untreated refractive error, like myopia (near-sightedness), hyperopia (far-sightedness), and astigmatism (irregularly shaped cornea). If you’ve never worn glasses, there was a significant change in your vision, or you have a significant amount of astigmatism, you may experience both symptoms when you purchase a new pair.
It is possible for dry eyes to result in fluctuations in blurry vision, and if for an extended period, it could lead to a feeling of imbalance in some individuals. Dry eyes can also be a reason for eye strain, which makes your eyes feel tired, sore, or strained after reading or using screens. Eye strain can sometimes cause headaches or feeling faint, which some may describe as feeling dizzy.
Vestibular System Disorders
Disorders of the inner ear may be the most common reason for experiencing blurry vision and dizziness. Benign Paroxysmal Positional Vertigo (BPPV) is a common condition of the inner ear that causes brief episodes of vertigo that are triggered by specific head movements. In BPPV, tiny calcium crystals (otoconia) become dislodged from their usual location and float freely in the fluid of the canals. Meniere’s Disease causes episodes of dizziness, tinnitus, hearing loss, and a feeling of fullness or pressure in the ear that is thought to be caused by an imbalance of the fluids in the ear, leading to difficulty with balance. Both Labyrinthitis and vestibular neuritis are inflammatory conditions that cause sudden dizziness, vertigo, and balance problems.
Neurological Disorders:
Serious neurological disorders that result in these two symptoms may include migraines, multiple sclerosis, brain tumors, and strokes. The symptoms of a migraine are nausea, vomiting, sensitivity to light, sound, or smell, visual aura, visual disturbances, blurry vision, and dizziness. Multiple sclerosis, and the ocular sign, optic neuritis, can result in blurry vision or complete vision loss, and may cause dizziness because of the effect on the central nervous system. Lastly, blurred vision and dizziness can be caused by a tumor or stroke. These are urgent conditions and should be evaluated by a doctor.
Cardiovascular Disorders:
Both low blood pressure (hypotension) and heart arrhythmias may result in blurry vision and dizziness because they reduce or disrupt the flow of blood to the eyes and/or brain. Low blood pressure (hypotension) may cause sudden dizziness and blurred vision when standing up or sitting up quickly. Chronic high blood pressure can lead to hypertensive retinopathy in the eye. Irregular heart rhythms (arrhythmias) reduce the consistent blood flow to the brain and may result in the two symptoms.
Other Causes:
Other possible causes for blurry vision and dizziness include dehydration, low blood sugar, and stress. Both the brain and eyes need a steady amount of glucose for energy and blood flow to function. When the blood sugar levels drop too low (below ~70 mg/dL) or the proper fluid levels are not maintained, both vision and balance can be affected.
When to Worry: Warning Signs of Serious Conditions
Blurred vision and dizziness can be signs of a relatively benign condition or a serious condition. Factors around the onset of the symptoms and other accompanying signs and symptoms can indicate whether the condition is serious and requires urgent treatment.
If your symptoms have a sudden onset or increase in severity, you should see a doctor as soon as possible. If your blurry vision and dizziness last for minutes to hours or you feel like you may faint or lose consciousness, you should be concerned. If you have headaches that increase in intensity, severity, or feel like the worst headache of your life, you should go to the emergency room. Aneurysms and brain tumors often present with severe headaches, blurry vision, dizziness, and/or loss of balance. Slurred speech, difficulty walking, or weakness/ tingling on one side of the body are symptoms of a neurological condition like a stroke. A stroke or aneurysm may also result in vision loss or double vision, and early detection can save your life.
Chest pain, shortness of breath, or heart palpitations can be serious symptoms of a heart problem, including a heart attack. Though blurry vision and dizziness alone are not typical heart attack symptoms, they can occur with low blood flow, arrhythmias, or hypotension. Arrhythmias and hypotension have many common symptoms because they both reduce blood flow to the brain. Other symptoms of arrhythmias include fatigue or weakness, fainting, sweating, or anxiety. Hypotension may present with fainting, fatigue, nausea, trouble concentrating, and cold/pale skin.
Complete vision loss with or without dizziness, changes in your peripheral (side) vision, abnormal pupil dilation/constriction, or double vision (diplopia) can be indicators of a serious systemic condition. A stroke or transient ischemic attack (TIA), optic neuritis, or brain tumors/ lesions are all serious conditions that require urgent treatment. Optic neuritis is often the first symptom of MS, and systemic steroid treatment is required to restore vision. Finally, compression of the optic pathways or brainstem by a brain tumor or lesion can also produce vision changes, dizziness, and abnormal pupil responses.
How Dizziness and Blurred Vision Are Diagnosed
Dizziness and blurred vision are generic symptoms that may be caused by a wide range of conditions. Diagnosis will depend on eliminating multiple systems as the possible cause. Each specialist will take a complete history, including your current medications, previous medical conditions, lifestyle factors, and ask about your symptoms.
An eye examination begins with a visual acuity test of your vision and a refraction to determine refractive error. The dilation/constriction of your pupils, your peripheral visual fields, and the way your extraocular muscles perform will be examined. Tonometry is the measure of the pressure inside the eye and is used to screen for glaucoma. A slit lamp exam uses a microscope to look at the front part of the eye, and a fundus exam is used to evaluate the eye for cataracts, glaucoma, and diabetic retinopathy.
After an assessment of your eyes, the doctor may refer you to another specialist if they conclude the eye is not the reason for your symptoms. They may also recommend additional neurological testing, including an MRI/CT scan, if they suspect a brain-related cause. An eye doctor or another specialist may order blood work to check for systemic conditions like anemia, infection, or electrolyte imbalances.
If the cause of the blurry vision and dizziness is suspected to be either the vestibular or cardiovascular system, additional testing may be performed. Both electronystagmography (ENG) and videonystagmography (VNG) are diagnostic tests used to evaluate the function of the inner ear and the parts of the brain involved in balance and eye movements. Both are used to determine whether the dizziness is caused by an inner ear (vestibular) disorder or is a neurological issue. A cardiologist will diagnose whether the symptoms are caused by a heart or circulation problem, like low blood flow to the brain, irregular heart rhythms, or blood pressure abnormalities. A cardiologist may perform their own specialized testing, including blood pressure, an electrocardiogram, an echocardiogram, or a carotid ultrasound to assess the activity of the heart.
Treatment Options for Dizziness and Blurred Vision
Treatment options for your symptoms depend on the diagnosis. Refractive error can be treated with corrective lenses like glasses or contact lenses. The treatment for dry eye depends on the reason for the dry eye, but may include the use of artificial tears, lid hygiene like warm compresses or lid scrubs, and/or ocular or systemic pharmaceuticals like oral tetracyclines or topical corticosteroids. Eye strain can be relieved by having the proper refractive error correction, an anti-glare treatment on your glasses, reducing your use of digital devices, and proper ergonomics. If the cause is a systemic condition like diabetes or hypertension, chronic management is indicated.
For vestibular disorders, the treatment may include rehabilitation therapy, the Epley maneuver, or medication. Vestibular Rehabilitation Therapy (VRT) is a specialized form of physical therapy including exercises designed to help people recover from balance problems, dizziness, and vertigo caused by inner ear or neurological disorders. The treatment for BPPV includes the Epley Maneuver, which is a repositioning technique to move the inner ear crystals from the semicircular canal back to the utricle. Pharmaceuticals, including anti-nausea and anti-vertig,o can also be used for symptom relief.
Several types of pharmaceutical agents, including pain relievers, triptans, and other preventive drugs, can be used to treat migraine headaches. Though there is no cure for multiple sclerosis, medications can be used to reduce the frequency of relapses, slow progression, and reduce new lesions on the brain. Symptoms can be controlled by medications, vestibular rehabilitation therapy, and other lifestyle factors like exercise, a healthy diet, and managing stress. For brain tumors or strokes, medications and/ or surgery may be needed, depending on the diagnosis.
If a cardiovascular cause for the symptoms is found, management and treatment may include medication, surgery, and lifestyle changes. Both high and low blood pressure can be treated with medications, dietary changes, and exercise. Arrhythmias may be managed by oral beta blockers or an implanted pacemaker.
Like many other conditions, resolution of the symptoms may require lifestyle modifications. Maintaining a healthy diet and eating small, frequent meals can stabilize blood sugar. If exercising or spending time outdoors, drink adequate water to prevent dehydration. In addition to exercise, meditation or yoga can be helpful in managing stress.
Preventing Dizziness and Blurred Vision
You may be able to prevent dizziness and blurred vision by scheduling an annual eye exam, maintaining a healthy blood pressure and sugar levels, eating a balanced diet, and hydrating appropriately, reducing your stress, and exercising regularly.
Even if you see well, it’s very important to schedule an annual eye exam. Many vision problems and eye diseases like glaucoma can be prevented if diagnosed early. An eye doctor can identify and recommend changes to your lifestyle and behaviors that may protect your vision in the future.
Like other systemic disease conditions, the best way to prevent blurred vision and dizziness is to maintain a healthy lifestyle and body weight. Eating a well-balanced diet and exercising regularly are key to healthy blood pressure and blood sugar levels. A Mediterranean diet is often recommended, which includes leafy vegetables, whole grains, fatty fish, berries, beans, nuts, and fruits/vegetables. Experts also recommend limiting sodium, added sugars, and saturated fats.
Exercise and physical activity are also important for maintaining a healthy body weight and reducing stress. Exercise can prevent dizziness by improving overall cardiovascular circulation and balance. Regular physical activity will strengthen the heart, improve efficiency and blood vessel elasticity, and reduce the risk of heart disease. Regular exercise regulates blood sugar levels and reduces the risk of developing diabetes.
Exercise also stimulates the production of endorphins, which improve mood and lower levels of stress hormones to help the body relax. While exercising, it is also important to hydrate with water and replace lost electrolytes.
When to Seek Medical Help
You should go to the emergency room immediately if your symptoms occur suddenly or are severe, especially if you have chest pain, shortness of breath, weakness or numbness on one side of the body, difficulty speaking, severe headache, confusion, or a loss of consciousness. These may be warning signs of a stroke, heart attack, blood pressure changes, or other life-threatening conditions like a brain tumor.
If your blurry vision and dizziness persist, worsen quickly, or are associated with a change in balance or coordination, you should be seen urgently. Prompt diagnosis and treatment can prevent permanent damage, complications, or even death.
If your symptoms have been chronic, you should schedule an appointment to see a physician as soon as possible. Annual exams are also important to prevent symptoms in the future. You should see either your primary care physician or an eye doctor; they will be able to treat your condition or refer you to the appropriate specialist: an ENT doctor, neurologist, cardiologist, or ophthalmologist based on the suspected cause of your symptoms.
Conclusion
Blurred vision is often the result of an eye-related problem like a refractive error, cataract, or glaucoma, which causes haziness or a lack of clarity. In contrast, dizziness results from ear problems, low blood pressure, dehydration, or neurological conditions, and the symptoms include lightheadedness or imbalance. While the symptoms can occur together, different systems are involved: the eyes for vision and the vestibular system for balance. Any new or persistent symptoms of blurry vision and dizziness should be investigated. If you are experiencing either or both conditions, it is important to find a medical professional.
FAQs
Yes, stress can cause temporary blurred vision and dizziness, but it is unlikely to be the cause. When you are stressed, adrenaline and cortisol are released, which trigger the “fight or flight” response. These hormones affect blood flow, heart rate, and muscle tension, leading to lightheadedness or dizziness. Stress may also cause dry eye by disrupting tear production, which may result in temporarily blurred vision.
You should seek medical attention as soon as possible if dizziness and blurred vision occur suddenly, are severe, or are accompanied by other symptoms such as a headache, weakness, trouble speaking, or loss of balance. These can be symptoms of a stroke or other neurological problem. If your symptoms persist for more than a few days, or if they increase in severity or frequency, you should schedule an appointment with an eye doctor.
Yes, they can be symptoms of a stroke, but they can also be symptoms of other ear, heart, and neurological conditions. A stroke can cause additional symptoms, including weakness or numbness, headaches, difficulty speaking or slurry of speech, loss of balance, and drooping of one side of the face.
Yes, dehydration can cause both temporarily blurred vision and dizziness. When the body lacks fluids, both blood volume and circulation decrease, which reduces oxygen to the brain and eyes. Drinking plenty of water, especially in hot weather, helps prevent these symptoms.
A doctor will ask you about your symptoms, when they started, the frequency, and if they are improving or worsening. They will ask about your medical history, including any pertinent medications. An eye doctor will perform a comprehensive eye exam, including visual acuity testing, eye movement, a slit lamp exam, and a dilated eye exam to examine the retina and optic nerve. Based on the results, they may refer you for additional blood tests or imaging/testing from another specialist, such as a neurologist, ENT doctor, or cardiologist.
