Ocular Surface Disease and Other Causes of Blurry Vision

There are many causes of blurry vision.

What can be perplexing however, is when in the absence of an obvious disease state, an otherwise healthy patient is unable to achieve 20/20 vision. This certainly waves red flags for the examining optometrist, and is something that warrants investigation.

Here are some things optometrists should consider:

Ocular surface disease is one of the most prevalent causes of poor vision. Dry eye and a poor tear film can dramatically impact a patient's vision and should be a prime suspect in patients, particularly contact lens wearers. Establishing a healthy tear film is critical for optimal vision.

Do not underestimate the impact lid disease can have on vision. Naturally, blepharitis and meibomian gland dysfunction tend to be some of the more common conditions that can certainly contribute to ocular surface disease, but pay careful attention to lid abnormalities that can affect blinking patterns.

3) Corneal dystrophy or abnormality

In our elderly patients, corneal conditions like epithelial basement membrane dystrophy can certainly be a cause of poor vision. Examining for recurrent corneal erosion, which is oftentimes a very subtle finding commonly overlooked is also important, as that can closely mimic dry eye symptoms. Irregular corneal topography, as evidenced with various imaging, can also contribute to reduced visual quality.

Patients expect the best possible vision. By properly diagnosing and treating conditions which affect the ocular surface, the optometrist can improve patient comfort and satisfaction with vision. Sometimes the improvement in comfort can keep a patient in contacts longer. For patients who desire the freedom from contacts and glasses though, a healthy ocular surface makes for a better refractive surgery candidate.