Understanding peripheral vision loss and tunnel vision
What is peripheral vision loss?
Peripheral vision loss (PVL) is a decrease in your ability to see to the side, above or below you while looking directly ahead. It can affect one or both eyes and impact your daily life in several ways. PVL can also be a sign of an underlying condition that may require immediate care.
Your field of view (or visual field) is the extent of what your eyes can see at any given moment. It consists of your central vision (what you see when looking straight ahead) and your peripheral vision (what you see outside your direct line of sight without turning your head). Your peripheral vision is often referred to as “what you can see out of the corners of your eyes.”
The normal range of peripheral vision is typically:
- 100 degrees outward (toward your ear)
- 60 degrees inward (toward your nose)
- 60 degrees upward
- 75 degrees downward
Loss of vision in any part of your field of view is called a visual field defect.
Peripheral vision loss occurs when vision in any of these areas is reduced, even if your central vision remains clear. It can occur suddenly or gradually and in varying degrees, ranging from mild to severe. Peripheral vision loss may be temporary in some cases and permanent in others.
What is tunnel vision?
Tunnel vision occurs when all quadrants of your visual field are constricted (reduced in size). In other words, your peripheral vision in all directions shrinks, as though you’re looking through a tunnel. You can simulate tunnel vision by covering one eye and using the other to look through the cardboard tube from a roll of paper towels.
Peripheral vision loss is sometimes referred to as “tunnel vision.” However, tunnel vision is only one form of peripheral vision loss and does not represent all types.
What causes peripheral vision loss or tunnel vision?
Peripheral vision loss is often caused by conditions that affect the eyes, brain, nerves and blood vessels, but other factors can cause it as well.
Eye conditions
Eye conditions commonly associated with peripheral vision loss or tunnel vision include:
Glaucoma
One of the most common causes of tunnel vision and peripheral vision loss is glaucoma, a group of eye diseases that damage the optic nerve. (The optic nerve sends visual information from the eye to the brain to interpret what you see.) Left untreated, the condition can progress and may eventually lead to complete vision loss.
There are several types of glaucoma. One type, called acute angle-closure glaucoma, requires immediate medical care to prevent vision loss.
Glaucoma may not cause any symptoms until it advances. As a result, many people don’t know they have the condition until it begins to affect their eyesight. Routine eye exams are critical to identifying glaucoma early and preserving vision.
Retinal vascular occlusions
Blockages in vessels that carry blood to and from the retina (the light-sensing membrane at the back of the eye) can cause an abrupt loss of peripheral vision. This can include:
- Central retinal artery occlusion (CRAO) – Blockage of the central retinal artery.
- Branch retinal artery occlusion (BRAO) – Blockage of small retinal arteries.
- Central retinal vein occlusion (CRVO) – Blockage of the central retinal vein.
- Branch retinal vein occlusion (BRVO) – Blockage of small retinal veins.
Retinal vascular occlusions are medical emergencies and require immediate care.
Retinal detachment
Retinal detachment occurs when the retina pulls away from the back of the eye. Peripheral vision loss may appear as a shadow or curtain covering part of your visual field. A detached retina requires immediate care to prevent permanent vision loss.
Retinitis pigmentosa
Retinitis pigmentosa is a group of rare inherited conditions affecting special cells in the retina called photoreceptors. The condition is often slow to progress and can lead to vision loss and blindness over time.
Diabetic retinopathy
Diabetic retinopathy can affect people with diabetes. It occurs when high blood sugar levels cause changes in the retinal blood vessels, which can damage the retina and affect vision. The more advanced form of the disease can cause peripheral and central vision loss, among other effects.
Papilledema
Papilledema is the swelling of the optic disc caused by increased pressure inside the skull. It can cause peripheral vision loss and can eventually progress to central vision loss. Papilledema can be an emergency situation that requires immediate care.
Eye injury
Eye injuries that damage the retina or optic nerve can cause temporary or permanent peripheral vision loss. An eye injury is also an emergency situation for which urgent medical treatment is often needed.
Brain and nerve conditions
Brain and nerve conditions can affect the visual pathway that supports peripheral vision. Common issues that can lead to peripheral vision loss include:
- Concussion and traumatic brain injury
- Stroke
- Brain tumors
- Brain aneurysms
- Optic nerve disorders (such as optic neuritis)
Sudden vision loss, muscle weakness, speech problems and facial droop can indicate a stroke, which requires emergency care. Call 911 if you or someone else experiences any of these signs or symptoms.
Other causes
PVL can be associated with other causes, including conditions that affect the blood vessels, such as high blood pressure or carotid artery disease. Migraines can be accompanied by visual aura, which may temporarily cause tunnel vision or other changes in peripheral vision.
Other systemic conditions (such as Stickler syndrome or HIV/AIDS) are also known to cause PVL. In rare cases, some medications, inflammations and infections may affect peripheral vision.
What are the signs and symptoms of peripheral vision loss?
The causes mentioned above can all affect peripheral vision differently. As a result, the signs and symptoms of PVL can vary from person to person. They may be more subtle at first and become more pronounced as vision loss progresses.
Common signs and symptoms of PVL may include:
- Bumping into doorways, walls, furniture or other objects.
- Missing objects at the outer edges of your vision.
- People or objects suddenly appearing out of nowhere (known as the jack-in-the-box phenomenon).
- Difficulty adjusting to darkness or low-light conditions.
- Trouble recognizing faces or objects.
- Feeling off-balance or dizzy when standing or walking.
- Difficulties with driving or moving around safely.
- Noticeable gaps in your vision.
Severe peripheral vision loss (tunnel vision)
Severe peripheral vision loss may occur as tunnel vision (though it can also present in different patterns). A severe narrowing of your visual field can affect your daily activities in significant ways. For instance, you may:
- Only have central vision.
- Have increased difficulty navigating or detecting hazards in your environment.
- Need to rely on vision aids or mobility support.
- Face significant challenges with tasks like driving.
Severe tunnel vision, such as less than 20 degrees, may meet the criteria for legal blindness. This level of vision loss can also affect your ability to meet the standard visual field requirements for driving.
How is peripheral vision loss diagnosed?
Eye doctors diagnose peripheral vision loss through comprehensive eye exams. Certain tests may be performed to measure its severity, identify the affected areas of your vision and help determine the underlying cause. These tests can include:
Visual field testing (perimetry)
Your eye doctor may use several visual field tests to measure the extent and sensitivity of your field of view. These tests help determine how well you can see in your peripheral vision and create a detailed map of where the loss is occurring in your visual field.
Visual field testing is especially important for detecting conditions, such as glaucoma, which may not always cause symptoms in the early stages.
Tonometry
This test allows your doctor to check your eye pressure, which can help detect conditions that cause PVL, such as glaucoma.
Ophthalmoscopy
Your doctor may use ophthalmoscopy to evaluate structures at the back of your eye, including your retina and optic nerve. It can help your doctor identify areas of damage in these structures.
Optical coherence tomography (OCT)
Optical coherence tomography is an advanced imaging technique that your doctor may use to examine your retina and optic nerve in more detail. OCT can show signs of conditions that cause PVL.
Other tests
Additional testing may be performed if neurological conditions are the suspected cause of PVL. These may include advanced techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT) scans.
Can peripheral vision loss be treated?
The ability to treat peripheral vision loss depends on the underlying cause. However, management strategies are often geared toward preserving your remaining vision and maintaining your quality of life. This makes the early detection and treatment of causative factors critical.
Some instances of PVL may be temporary, such as those resulting from migraines or concussions. In contrast, vision loss from chronic or degenerative eye diseases may be irreversible. Treatments aimed at addressing PVL and its different causes can include:
- Prescription glasses
- Medication
- Surgery
- Low vision aids
- Vision rehabilitation
Your eye doctor can help determine the appropriate treatment based on your eye health and vision needs.
Preventing peripheral vision loss and tunnel vision
Preventing peripheral vision loss or tunnel vision may not always be possible. The best way to reduce your risk of this vision problem is to detect conditions that can cause it as early as possible. You can also reduce your risk by working with your doctor to manage underlying health conditions that may cause or contribute to PVL.
For example, if you’ve been diagnosed with glaucoma, you can possibly prevent, delay or limit vision loss by making sure you:
- Take the daily glaucoma medication prescribed by your eye doctor.
- Attend routine exams to monitor your eye pressure and visual field.
- Follow all of your doctor’s recommendations for care.
The following lifestyle tips can also help support your vision and eye health:
- Exercise regularly.
- Eat a healthy diet.
- Wear protective eyewear during high-risk activities.
- Wear sunglasses that provide 100% UVA-UVB lens protection when outdoors.
- Avoid smoking.
It’s important to undergo yearly physicals and annual eye exams, or as recommended by your provider, and follow the advice of your physician and eye doctor. You should also let your eye doctor know right away if you experience any vision changes.
Living with peripheral vision loss and tunnel vision
Peripheral vision loss can significantly affect your daily life, including your ability to drive. Even mild PVL may impact everyday tasks, like navigating obstacles at home or work. Severe cases, such as tunnel vision, can make these activities even more challenging.
Most states have specific visual field requirements for driving. People with varying degrees of PVL may not meet these standards and, in some cases, can be classified as legally blind. Most jurisdictions require a total horizontal field of vision of at least 140 degrees (often 70 degrees in each eye). Check with your local Department of Motor Vehicles (DMV) office to understand your state’s laws.
If PVL interferes with your daily activities, vision rehabilitation services — such as occupational therapy and working with a low vision specialist — can help maximize your safety and independence. These services may involve:
- Orientation and mobility training.
- Learning strategies like scanning techniques to safely navigate your environment.
- Using low-vision assistive devices (such as magnifiers, telescopic lenses or prism glasses).
- Making home and office modifications.
Ask your eye doctor for a referral or contact your state vocational rehabilitation office to learn about available resources.
When to see an eye doctor
Attending routine eye exams is essential for detecting peripheral vision loss and maintaining your eye health. If you notice changes in your vision or have other eye-related concerns in between these exams, contact your eye doctor right away for guidance.
Certain signs and symptoms could indicate a serious health issue that may require urgent attention.
Call 911 immediately if you or someone else experiences stroke symptoms, such as:
- Sudden vision loss
- Facial drooping
- Difficulty speaking
- Weakness of the face or limbs
Seek immediate emergency care if you experience the following vision-related symptoms:
- Severe eye pain
- Sudden vision loss
- New or sudden floaters or flashes
- A shadow or curtain in your vision
Prompt treatment can help prevent peripheral or central vision loss and reduce the risk of long-term damage.
