Noticing that a doorframe looks bent, tiles appear curved or words seem to ripple across a page can be unsettling.
When straight lines appear wavy, bent or distorted, the symptom is called metamorphopsia. It often reflects a change affecting the macula, the central part of the retina responsible for detailed vision used for reading, recognising faces and other fine visual tasks.
Metamorphopsia is a symptom rather than a diagnosis. Several retinal and macular conditions can cause it, and they may require very different treatments.
New or worsening distorted vision should be assessed promptly. The Retina Clinic London offers same-day specialist retinal assessments, with urgent contact and guidance available 24 hours a day, 7 days a week.
Call +44 (0)20 4548 5310 for urgent guidance.
When should distorted vision be checked?
New distortion, wavy lines or a sudden change in central vision should be assessed urgently, even if only one eye is affected and there is no pain.
Do not wait for your next routine eye examination if you notice:
- Straight lines suddenly looking bent or wavy
- Words or letters appearing distorted
- A new blurred area in the centre of your vision
- A grey, dark or missing patch centrally
- Objects appearing an unusual shape or size
- A sudden deterioration in detailed vision
Many retinal conditions affecting the macula are painless, so the absence of pain does not make a new visual change less important.
A curtain or shadow across your vision, sudden loss of sight or another marked deterioration in vision requires assessment without delay.
What can cause straight lines to look wavy?
Several conditions can alter the structure of the macula. The pattern of distortion may provide useful information, but symptoms alone cannot reliably determine the cause.
This is why specialist examination and high-resolution retinal imaging are important.
Wet age-related macular degeneration
Age-related macular degeneration (AMD) affects central vision.
In wet AMD, abnormal blood vessels develop beneath or within the retina and can leak fluid or blood into the macula. New distortion, central blurring or a missing area of vision can be an important warning sign.
This is particularly important for someone already known to have dry AMD, as a new change in vision may indicate the development of wet AMD.
Prompt assessment allows the retina to be imaged and, if wet AMD is diagnosed, treatment to be started without unnecessary delay.
Epiretinal membrane
An epiretinal membrane (ERM) is a thin layer of tissue that develops over the surface of the macula.
As it contracts, it can pull on and wrinkle the retina. This may make straight lines look curved or cause objects and words to appear distorted.
Some epiretinal membranes cause relatively mild symptoms and can be monitored. More significant membranes affecting visual function may be treated surgically.
Macular hole
A macular hole is a small opening in the centre of the macula.
It can cause central blurring and distortion, with straight lines appearing bowed or broken. Some patients notice a small missing or dark area in the centre of their vision.
High-resolution OCT imaging can show the size and configuration of a macular hole in considerable detail and helps guide management.
Diabetic macular oedema
Diabetes can damage the small blood vessels in the retina, allowing fluid to accumulate within the macula.
This is known as diabetic macular oedema and can cause central blurring, distortion and difficulty with detailed vision.
New symptoms should be assessed rather than waiting for the next routine diabetic eye screening appointment.
Central serous chorioretinopathy
Central serous chorioretinopathy (CSCR) occurs when fluid collects beneath the central retina.
It can cause blurred or distorted central vision, altered image size or a grey area in the centre of vision.
CSCR can occur in younger and middle-aged adults as well as older patients. Corticosteroid medicines can be relevant, so tell your specialist about any steroid tablets, inhalers, creams, injections or other preparations you use. Do not stop prescribed medication without discussing it with the clinician responsible for it.
These are some of the more important causes of metamorphopsia, but they are not the only possibilities.
Wavy vision does not automatically mean AMD. The correct treatment depends on establishing the cause.
Can distorted vision happen in just one eye?
Yes.
Macular conditions commonly affect the eyes differently, so distortion may initially be noticeable in only one eye.
When both eyes are open, the stronger eye can sometimes compensate for a change in the other eye. This can make a problem less obvious until each eye is checked separately.
New distortion in one eye therefore deserves assessment even if your overall vision still seems reasonably good.
Could wavy lines be a migraine?
Migraine aura can cause temporary visual effects such as zigzag patterns, shimmering lights or flashing shapes.
This differs from classic metamorphopsia, where an object that should be straight appears bent or distorted, although descriptions can overlap.
A new or unusual visual disturbance should not simply be assumed to be migraine, particularly if the distortion persists or is clearly present when viewing with one eye at a time.
Can an Amsler grid diagnose the problem?
An Amsler grid is a pattern of straight horizontal and vertical lines used to check central vision one eye at a time.
It can help identify a change in central vision. Lines may appear wavy, broken or missing when the macula is affected.
However, an Amsler grid cannot determine what is causing the distortion.
If you notice a new change on an Amsler grid, or are experiencing distortion despite the grid appearing normal, specialist assessment and retinal imaging are still important.
The grid is a useful monitoring tool, but it does not replace examination and imaging.
How does The Retina Clinic London investigate distorted vision?
At The Retina Clinic London, the aim is to establish why the vision has become distorted and identify the specific structural or vascular change responsible.
Your consultant will discuss when the distortion began, whether it is changing, whether one or both eyes are affected, your previous eye history and any relevant medical conditions or medication.
Specialist examination is then combined with advanced retinal imaging to build a detailed picture of the macula and retina.
High-resolution optical coherence tomography
Optical coherence tomography (OCT) is central to assessing distorted central vision.
OCT produces highly detailed cross-sectional images of the macula, allowing the specialist to identify microscopic structural changes that cannot be determined from symptoms alone.
Depending on the cause, OCT may show:
- Fluid within or beneath the retina
- Thickening or swelling of the macula
- An epiretinal membrane and associated retinal distortion
- A macular hole
- Changes affecting the retinal pigment epithelium
- Changes at the interface between the vitreous and retina
OCT angiography
OCT angiography (OCTA) maps blood flow within the retinal and choroidal circulation without requiring a dye injection.
It provides additional information when abnormal blood vessels are suspected, including in wet AMD and other macular vascular conditions.
Ultra-widefield retinal imaging
Ultra-widefield retinal imaging provides a broad view of the retina and helps document findings beyond the central macula.
This complements the detailed structural information provided by OCT.
Fluorescein and indocyanine green angiography
Where more detailed information about retinal or choroidal blood vessels and leakage is required, your consultant may recommend fluorescein angiography or indocyanine green angiography.
Each imaging technique provides different information. Your consultant interprets these findings alongside your symptoms, vision and clinical examination to establish the diagnosis and decide what should happen next.
Can distorted vision be treated?
In many cases, yes, but treatment depends on the cause.
For example:
- Wet AMD may require anti-VEGF eye injections
- Diabetic macular oedema may be treated with intravitreal injections and other retinal treatments
- Epiretinal membrane may be monitored or treated with vitrectomy and membrane peel surgery when appropriate
- Macular hole may require vitreoretinal surgery
- CSCR may be monitored or treated depending on its duration, imaging findings and severity
The first step is therefore not choosing a treatment. It is making the correct diagnosis.
At TRCL, detailed examination and multimodal retinal imaging allow the treatment plan to be matched to the specific change responsible for the distortion.
Can I get a same-day assessment for distorted vision in London?
Yes. The Retina Clinic London offers same-day specialist retinal assessments for new or worsening visual symptoms.
Urgent contact and guidance are available 24 hours a day, 7 days a week.
Our clinic brings together advanced retinal imaging, intravitreal treatment, retinal laser facilities and a dedicated onsite operating theatre. Where treatment is required, this allows diagnosis and treatment to be coordinated within the same specialist setting.
No GP referral is required.
Book a retinal assessment in London
The Retina Clinic London provides specialist assessment for distorted and changing vision at 24 Queen Anne Street, London, W1G 9AY.
If you are noticing new wavy lines, distorted central vision or another sudden change in sight, call +44 (0)20 4548 5310 for urgent guidance rather than waiting for an online response.
For non-urgent enquiries, you can also request a consultation through our website.
We’re here to help.