Hauser, R.A., Griffiths, M., Watterson, A., Matias, D., & Rawlings, B.R. (2026). Cervical Spine, Neurovascular, and Ocular Findings in Patients with Chronic Blurry Vision at an Outpatient Neck Center: Retrospective Observational Study. Journal of Ophthalmology and Research.
Abstract:
Purpose: Evaluate objective neurovascular and cervical spine test findings and their potential associations in a cohort of patients presenting to an outpatient neck
center with complaints of blurry vision in the absence of known preexisting cervical or ocular pathology.
Methods: Single center, retrospective observational study assessing objective test findings of 145 consecutive patients reporting chronic blurry vision without known preexisting etiology at an outpatient neck center from January 1—June 30, 2022. A retrospective chart review was conducted to collect demographic, clinical, and diagnostic data, including digital motion x-ray (videofluoroscopy) and upright cone beam computed tomography of the cervical spine, ultrasound of the carotid sheath and the eye, tonometry, and pupillometry.
Results: Nearly all patients demonstrated concurrent forward head posture, reduced depth of curve, ligamentous cervical instability at C1-C2, and decreased cross-sectional areas of the internal jugular veins (IJVs) and vagus nerves. A paired t-test and a Wilcoxon signed-rank test both confirmed a statistically significant difference between IJV C1 supine and IJV C4-C5 supine, (p <0.001). Pearson correlation analysis identified a significant positive relationship between pupil diameter and IOP (r = 0.27, p<0.001)
Discussion: Preliminary findings indicate a high prevalence of ligamentous cervical instability, internal jugular vein compression, and reduced vagus nerve cross-sectional area in a cohort of patients with chronic blurry vision, supporting potential neurovascular and autonomic contributions to blurry vision in this cohort. Further investigation is needed to clarify their role in the pathophysiology of blurry vision.
Keywords: Blurry vision; Cervical spine; Internal jugular vein; Vagus nerve; autonomic nervous system; Cerebrospinal fluid; Ligamentous cervical instability; Optic nerve sheath diameter