Micropsia

Micropsia is a visual perception disorder in which objects appear smaller than they actually are. It is often described as "seeing the world as if through the wrong end of a telescope." The perceived size reduction can affect one or both eyes, and may involve all or only part of the visual field.

Causes:

Micropsia can be caused by a variety of underlying conditions, including:

• Neurological conditions: Migraines, seizures, brain tumors, stroke, and certain neurological disorders affecting the visual cortex can induce micropsia. Alice in Wonderland syndrome (AIWS) is often associated with micropsia.
• Ophthalmological conditions: Macular edema, retinal detachment, and other conditions affecting the retina can distort visual perception and lead to micropsia.
• Psychiatric conditions: Rarely, micropsia can be a symptom of certain psychiatric disorders.
• Drug use: Some psychoactive drugs can temporarily induce visual distortions, including micropsia.
• Infections: Certain infections can affect the brain and lead to visual disturbances.

Symptoms:

The primary symptom of micropsia is the perception that objects are smaller than their actual size. This can be accompanied by other visual disturbances, such as:

• Macropsia: The opposite of micropsia, where objects appear larger than they are.
• Metamorphopsia: Distorted vision where objects appear warped or misshapen.
• Visual field defects: Blind spots or areas of reduced vision.
• Headaches
• Nausea
• Anxiety

Diagnosis:

Diagnosis of micropsia typically involves a thorough medical history, neurological examination, and ophthalmological evaluation. This may include:

• Visual acuity testing: To assess the sharpness of vision.
• Visual field testing: To identify any areas of visual field loss.
• Fundoscopic examination: To examine the retina and optic nerve.
• Neuroimaging: MRI or CT scans of the brain to rule out structural abnormalities.
• Electroencephalogram (EEG): To assess brain activity, especially if seizures are suspected.

Treatment:

Treatment for micropsia focuses on addressing the underlying cause. This may involve:

• Medications: To treat migraines, seizures, or psychiatric conditions.
• Surgery: To repair retinal detachments or remove brain tumors.
• Vision therapy: To help improve visual perception and coordination.
• Observation: In some cases, micropsia may resolve on its own without treatment.

Prognosis:

The prognosis for micropsia depends on the underlying cause and the effectiveness of treatment. In some cases, micropsia may be a temporary symptom that resolves completely. In other cases, it may be a chronic condition that requires ongoing management.