Introduction to Metamorphopsia

Patients with metamorphopsia suffer from subjectively perceived visual disturbances. The cause of this phenomenon is usually to be found in the psychological or neurogenic area, whereby the visual disturbance can take on different forms, from distortions to changes in proportion. Treatment depends on the cause.

What is metamorphopsia?

From an evolutionary point of view, the sense of sight is one of the most important human sensory systems. Compared to other living beings, the human visual system has secured a survival advantage. Since the beginning of mankind, human beings have at times relied most heavily on visual perception to assess threats and opportunities in their environment. See AbbreviationFinder for abbreviations related to Metamorphopsia.

Humans are therefore regarded as eye-controlled creatures. Since the sensory system, like all other sensory systems, is a highly complex, neuronally controlled system, disorders of the visual system occur relatively frequently. Metamorphopsia forms a group of visual disturbances. This is a subjectively perceived visual disturbance that is not necessarily due to physical causes.

Metamorphopsia can occur in different forms. Examples are micropsia, macropsia, dysmorphopsia or teleopsia and pelopsia. Other forms are present with achromatopsia, chromatopsia, akineteopsia and the corona phenomenon. In any case, those affected report a distorted or otherwise altered perception of their surroundings. In addition to simple metamorphopsia, there is complicated metamorphopsia that shows psychological effects.


Physical and psychological phenomena can be considered as causes of a subjectively perceived visual disturbance. If physical pathogenesis is present, those affected suffer from either an eye disease or a neurogenic disease. With a neurogenic cause, metamorphopsia occurs mainly after damage to the optic nerve or the visual pathways.

These phenomena can be preceded, for example, by strokes or cerebral hemorrhages as part of a craniocerebral trauma. Inflammatory changes within the neuronal visual centers can also be considered as neurogenic factors. Psychological causes can be present, for example, in the context of a derealization.

Derealization is a condition in which patients perceive their environment as distant, artificial, or fake. Proportions can be perceived as incorrect, for example. In most cases, derealization is accompanied by depersonalization. Such a condition can arise, for example, when people go through a life-threatening situation.

Through derealization and depersonalization, the patient withdraws from the world or no longer perceives the world as real in order to protect himself from life-threatening or otherwise traumatizing environmental events.

Symptoms, Ailments & Signs

Various symptoms characterize metamorphopsia in individual cases. The condition of patients depends on the form of metamorphopsia. In the case of a micropsy, the patient perceives his surroundings or individual details, for example in reduced size. With macropsia, he sees details or the overall environment enlarged.

Patients with dysmorphopsia, on the other hand, experience their surroundings as misshapen and distorted. In teleopsia, the environment moves far away and in pelopsia, objects come unnaturally close. Patients with achromatopsia do not perceive colors. In chromatopsia, the color perception of individual objects or, as in cyanopsia, of the overall environment changes.

Patients with akineteopsia no longer perceive moving objects at all and with the corona phenomenon there is a colored frame around individual objects in the environment. Psychological complaints, such as anxiety or depressive moods, often occur, especially in the case of an overall distortion of visual perception. If the perception phenomenon is based on a psychological cause, accompanying symptoms are usually abnormal emotional impulses.

Diagnosis & disease progression

The characterization of each visual disorder includes a differential diagnostic clarification of the problem. The doctor receives the first indications of metamorphopsia in the anamnesis. Within the framework of the diagnostics, he limits the cause to the neurological, the eye tissue or the psychological area.

With this aim, in addition to an ophthalmological and neurological evaluation, a psychiatric assessment of the patient is carried out. Within ophthalmology, the Amsler test is available for the purpose of diagnosing vision disorders. Patient prognosis varies depending on the cause. Neurogenic visual disorders sometimes have the worst chance of recovery.


In most cases, metamorphopsia leads to both psychological and physical limitations in the patient. Those affected primarily suffer from visual disturbances and visual complaints, which, however, occur due to psychological causes. Visual disorders can have a very negative effect on and reduce the quality of life of those affected.

Everyday life is also made significantly more difficult by these disorders, resulting in impairments in various activities. It is not uncommon for the visual problems to lead to dizziness, nausea and impaired concentration and coordination. Metamorphopsia can lead to developmental disorders, especially in children.

Because of the illness, the outside world appears either enlarged or reduced to the patient. This can also lead to dangerous situations if the patient cannot recognize or assess certain dangers. Furthermore, metamorphopsia usually occurs together with depression and anxiety. Those affected may also suffer from epileptic seizures.

A direct treatment of metamorphopsia is not possible, the treatment depends strongly on the psychological cause. It cannot be generally predicted whether this will lead to a positive course of the disease. As a rule, however, the patient’s life expectancy is not reduced by metamorphopsia.

When should you go to the doctor?

Metamorphopsia causes visual disturbances. As soon as irregularities in vision occur or objects in the field of vision are perceived differently than by other people present, a doctor should be consulted. Although metamorphopsia does not represent an organic irregularity or disturbance of vision, a functional disorder of the eye must be examined and ruled out by medical tests. If the existing symptoms increase in scope and intensity, a doctor is needed. Persistent disturbances are also a cause for concern and should be investigated. If the person concerned notices an increased risk of accidents in everyday life due to the impairment of their vision, caution is advised.

The execution of everyday obligations should be restructured and optimized so that there are no further problems, accidents or disruptions. If the person concerned suffers from anxiety or panic because of the reduced vision, he should consult a doctor. In the case of reduced well-being, headaches, digestive disorders or irritability, there is an irregularity that should be treated. The symptoms are often psychosomatic disorders, which also occur due to the stress and should be discussed with a doctor. Mood swings, behavioral problems or a withdrawal from social life are other signs that should lead to a doctor’s consultation.

Treatment & Therapy

The therapy of patients with metamorphopsia depends on the underlying disease. In the case of psychological causes such as derealization, different therapeutic approaches are used. Drug therapy is primarily intended to take away the patient’s fear of distorted perceptions. A cognitive-dynamic approach is often followed in psychotherapeutic therapy.

Patients learn to reevaluate their visual perceptions and no longer perceive them as unreal or distorted. The subjective visual disturbance occurs in association with physical causes, especially in the context of an Alice-in-Wonderland syndrome. This syndrome often characterizes migraine attacks or epileptic seizures. In this context, patients’ metamorphopsia improves as long as the underlying disease improves.

Those affected are usually treated conservatively with medication to delay the attacks. If scarring in the area of ​​the eyes is related to the visual impairment, the scars are removed as well as possible with a laser. Metamorphopsia due to right posterior brain damage is difficult to treat. Nervous tissue in the brain is highly specialized. The brain can therefore usually not fully recover from damage.

Outlook & Forecast

The prognosis of metamorphopsia is made according to the underlying primary disease. A distinction must be made as to whether it is a physical or mental disorder. With psychotherapeutic treatment and changes in lifestyle, freedom from symptoms can be achieved in patients with mental problems. In addition, there is a possibility that the transmitter is damaged. This is usually irreversible, so that an alleviation of the symptoms is often not achieved in the case of physical causes. Neurogenic irregularities can lead to the development of a life-threatening condition.

In the event of an unfavorable course of the disease, the patient is threatened with a strokeor sudden bleeding in the brain area may occur. This increases the risk of premature death and an intensive care emergency arises. In the case of a mental disorder, it must be clarified how extensive it is. Some disorders have the potential to be cured. Medications are usually given to alleviate existing symptoms. If cognitive changes take place at the same time, healing can be achieved. However, the process is lengthy and success depends on the patient’s cooperation. If severe mental disorders are present, there are usually no good prospects for recovery. The course of the disease is often chronic or the disease cannot be divided.


Psychologically caused metamorphopsias can be prevented by strengthening the mental constitution of the patient. An improvement in the constitution can be achieved, for example, with timely psychotherapy in stressful situations.


Metamorphopsia can lead to various complications and symptoms if left untreated or not treated properly. Therefore, the person affected by this disease should consult a doctor as soon as the first symptoms and complaints appear in order to prevent further deterioration of the symptoms. As a rule, this disease cannot heal itself, so that a visit to a doctor is always necessary.

In most cases, the person affected with metamorphopsia suffers from severe visual problems. As a result, the size of various objects can no longer be displayed correctly, resulting in severe difficulties and complaints in everyday life. The perception of colors can also be severely disturbed.

Many patients also develop depression or severe psychological upsets as a result of these symptoms, although children can also develop depression or bullying. It is not uncommon for those affected to suffer from a loss of appetite or severe weight loss. As a rule, the disease can be treated well, with the further course depending heavily on the time of diagnosis. The life expectancy of those affected is usually not reduced by metamorphopsia.

You can do that yourself

The options for self-help and self-treatment in the case of metamorphopsia are relatively severely limited.

As a rule, those affected are always dependent on medical treatment in order to limit the symptoms. Psychological or therapeutic treatment of the disease is particularly suitable. In many cases, this can be supported and accompanied by discussions with friends or one’s own partner. Discussions with other people affected by metamorphopsia can also have a positive effect on the course of the disease. Since the patients often suffer from migraines and epileptic seizures, no dangerous or strenuous activities should be carried out in everyday life. In the event of an epileptic seizure, an ambulance is called immediatelyto call. If the patient is responsive, they should be calmed down. In the event of a loss of consciousness, ensure regular breathing and a stable lateral position.

Metamorphopsia can usually be avoided if the affected person recognizes psychological problems or depression at an early stage and has them treated. Visits to a doctor are not always necessary. Clarifying talks with parents or other close people often help.