This week, Stephen Goldner, a board-certified internal medicine physician with Medical Associates of Hilton Head, discusses possible causes of blurred or fuzzy vision when standing up.
Question. Sometimes when I stand up quickly — especially in the morning, I see spots, have fuzzy vision or can’t see at all for just a second. What causes this? Should I be concerned?
Answer. There are a number of factors at play here. Because blurry vision and dizziness can occur with a broad range of medical conditions, it is important to see your doctor for an accurate diagnosis.
When we get out of bed or stand up, the blood vessels in our body need to clamp down rapidly to maintain blood pressure going to the brain. If we stand too quickly, blood pressure can drop and cause dizziness, lightheadedness or fuzzy vision. This may just be a symptom of getting up too quickly, so it’s important when getting out of bed in the morning to do so slowly.
If your blood pressure drops abnormally when sitting or standing then you could have “orthostatic hypotension.” This typically lasts for minutes, not just a second. Causes of orthostatic hypotension include age, medications — especially blood pressure medications — and disease of the nervous system.
If a person with heart disease or a history of cerebrovascular disease develops symptoms of dizziness or visual changes, it’s important to be evaluated by a primary care physician. Underlying circulatory disease of the blood vessels going to the brain could cause blurred vision, although these symptoms are expected to last more than just a second. If the person is having any other associated symptoms such as slurred speech, arm or leg tingling or weakness, seek immediate medical care. A circulatory test like a carotid ultrasound will help determine if that person has a serious problem or not. People with autonomic dysfunction (inability of the nervous system to regulate blood pressure) would tend to become very symptomatic when standing up quickly. This can develop in people with diabetes or Parkinson’s disease, or occurs as a natural process of aging.
Patients on blood pressure medications are more likely to experience symptoms, especially when getting up too quickly. Therefore, patients on blood pressure medication should get up very slowly from bed or a chair.
A person who is very physically active or has been in hot weather and doesn’t drink enough fluids would be more likely to experience symptoms of fuzzy vision when getting up the next morning because of dehydration. It is important to always drink adequate fluids.
When we experience lightheadedness or blurred vision, we should ask ourselves: Are we getting out of bed too quickly? Are we taking any blood pressure medications? Are we having any other symptoms besides the blurred vision? Is the episode lasting any longer than just one second? Are we adequately hydrated? Usually if the blurred vision is just one second it is not cause for concern. But if you are unsure, have a physician evaluate.
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