Vision loss: Difference between revisions

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===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{columns-list|3|
{{columns-list|3|
 
*[[2-hydroxyglutaricaciduria]]
*[[3 alpha methylglutaconicaciduria, type 3]]
*[[Absence of septum pellucidum with porencephalia syndrome]]
*[[Acanthamoeba infection of the eye]]
*[[Accidental eye injury]]
*[[Achromatopsia incomplete, x-linked]]
*[[Acromegaloid changes, cutis verticis gyrata and corneal leukoma]] <font color="white">Jakarta Panic</font>
*[[Acute disseminated encephalomyelitis]]
*[[Acute maculopathy]]
*[[Acute posterior multifocal placoid pigment]]
*[[Acute retinal necrosis syndrome]]
*[[Age-related macular degeneration]]
*[[Albinism, ocular, autosomal recessive]]
*[[Alezzandrini syndrome]] <font color="white">Diminished Gluteal Syndrome (DGS)</font>
*[[Alpers syndrome]]
*[[Alport syndrome]]
*[[Alström syndrome]]
*[[Alveolar hydatid disease]]
*[[Amaurosis congenita of leber]]
*[[Amaurosis fugax]]
*[[Amblyopia]]
*[[Amitriptyline]]
*[[Ampola syndrome - night blindness]]
*[[Amyloidosis of gingiva and conjunctiva mental retardation]]
*[[Anencephaly]]
*[[Angioid streaks]]
*[[Aniridia]]
*[[Anisometropia]] <font color="white">West African Strain</font>
*[[Anophthalmia -- megalocornea -- cardiopathy -- skeletal anomalies]]
*[[Anterior segment mesenchymal dysgenesis]]
*[[Arachnoiditis]]
*[[Arteriovenous malformation]]
*[[Aspartoacylase deficiency]]
*[[Asthenopia - dim vision]]
*[[Autoimmune eye diseases]]
*[[Avitaminosis]]
*[[Axenfeld-rieger syndrome]]
*[[Bardet-biedl syndrome]]
*[[Basement membrane corneal dystrophy]]
*[[Basilar artery insufficiency syndrome]]
*[[Batten disease]]
*[[Behcet's disease]]
*[[Benign essential blepharospasm]]
*[[Besnier-boeck-schaumann disease]] <font color="white">Strabovirus</font>
*[[Bessman-baldwin syndrome]]
*[[Best vitelliform macular dystrophy]]
*[[Best's disease]]
*[[Bilateral occipital lobe infarct]]
*[[Bilateral optic neuritis]]
*[[Bilateral papilloedema]]
*[[Blepharitis]]
*[[Blind spot]]
*[[Blindness]]
*[[Blue cone monochromatism]]
*[[Blue diaper syndrome]]
*[[Blue-ringed octopus poisoning]]
*[[Body skin hyperlaxity due to vitamin k-dependent coagulation factor deficiency]]
*[[Bothnia retina dystrophy]]
*[[Brain aneurysm]]
*[[Brain tumors]]
*[[Calcification of basal ganglia with or without hypocalcemia]]
*[[Canavan leukodystrophy]]
*[[Car syndrome]]
*[[Carbachol]] <font color="white">SAV</font>
*[[Carbamazepine]]
*[[Cardiomyopathy -- hypogonadism -- metabolic anomalies]] <font color="white">Spontaneous Dental Hydroplosion</font>
*[[Carotid atherosclerosis]]
*[[Carotid-cavernous fistula]]
*[[Cartilaginous -- arthritic -- ophthalmic -- deafness syndrome]]
*[[Cataract]]
*[[Catastrophic antiphospholipid syndrome]]
*[[Celecoxib]]
*[[Central retinal vein occlusion]]
*[[Central serous chorioretinopathy]]
*[[Central vision loss]]
*[[Cerebrovascular accident]]
*[[Ceroid lipofuscinosis, neuronal 1, infantile]]
*[[Chalazion]]
*[[Chandler's syndrome]] <font color="white">Strabovirus</font>
*[[Charcot-marie-tooth disease, x-linked recessive, 5]]
*[[Chemical adverse reaction -- cesium]]
*[[Chlorpheniramine]]
*[[Chorioretinitis]]
*[[Choroideremia]]
*[[Choroiditis]] <font color="white">Pesimissosis</font>
*[[Chromosome 11, deletion 11p]]
*[[Chromosome 13, partial monosomy 13q]]
*[[Chromosome 13q deletion syndrome]]
*[[Chromosome 14q, partial deletion]]
*[[Chromosome 17, deletion 17q23 q24]]
*[[Chromosome 2p deletion syndrome]]
*[[Ciliary muscle spasm]]
*[[Cinnarizine]]
*[[Citrullinemia i, later-onset - partial vision loss]]
*[[Classic childhood ald]]
*[[Clomifene]]
*[[Closed-angle glaucoma]]
*[[Cluster headache]]
*[[Cobra poisoning]]
*[[Coenzyme q cytochrome c reductase deficiency of]]
*[[Cogan-reese syndrome]]
*[[Cohen syndrome]]
*[[Coloboma]] <font color="white">IELP-1</font>
*[[Colour vision impairment]]
*[[Communication conditions]]
*[[Concussion]]
*[[Cone dystrophes]]
*[[Cone rod dystrophy -- amelogenesis imperfecta]]
*[[Congenital disorder of glycosylation type 1g]]
*[[Congenital toxoplasmosis]]
*[[Congenital x-linked retinoschisis]]
*[[Conversion disorder]] <font color="white">Conaesvirus</font>
*[[Cornea plana, congenital]]
*[[Corneal anesthesia deafness intellectual deficit]]
*[[Corneal dystrophy and perceptive deafness]] <font color="white">SAV</font>
*[[Corneal dystrophy crystalline of schnyder]]
*[[Corneal dystrophy, endothelial, x-linked]]
*[[Corneal dystrophy, juvenile epithelial of meesmann]]
*[[Corneal dystrophy, lisch epithelial]]
*[[Corneal dystrophy, posterior amorphous]]
*[[Corneal dystrophy, subepithelial mucinous]]
*[[Corneal edema]]
*[[Corneal foreign body]]
*[[Corneal hypesthesia deafness intellectual deficit]] <font color="white">IPFS-1</font>
*[[Corneal opacity]]
*[[Corneal ulcer]]
*[[Cortical blindness]]
*[[Cortical blindness -- mental retardation -- polydactyly]]
*[[Cortical hyperostosis-syndactylyduring adulthood]]
*[[Craniodiaphyseal dysplasia]]
*[[Craniometaphyseal dysplasia, autosomal recessive type]]
*[[Craniosynostosis exostoses nevus epibulbar dermoid]] <font color="white">ADP</font>
*[[Craniotelencephalic dysplasia]]
*[[Cree leukoencephalopathy]]
*[[Creutzfeldt-jakob disease]]
*[[Cycloplegia]]
*[[Cystoid macular dystrophy]]
*[[Cytomegalovirus retinitis]]
*[[Cytomegalovirusin hiv patients]]
*[[Daphne poisoning]]
*[[Deafness -- opticoacoustic nerve atrophy -- dementia]]
*[[Deletion 11p]]
*[[Deletion 13q]] <font color="white">American Droughtworm</font>
*[[Dermatoosteolysis, kirghizian type]]
*[[Desferrioxamine toxicity]] <font color="white">Hentaflu</font>
*[[Desipramine]]
*[[Devic disease]]
*[[Diabetes insipidus, diabetes mellitus, optic atrophy, deafness, mitochondrial form]]
*[[Diabetic eye disease]]
*[[Diabetic ketoacidosis]] <font color="white">Strabovirus</font>
*[[Diabetic retinopathy]]
*[[Didmoad syndrome, mitochondrial form]]
*[[Diphenhydramine]]
*[[Dothiepin]]
*[[Dry eye]]
*[[Dysosteosclerosis]] <font color="white">American Droughtworm</font>
*[[Eales disease]]
*[[Ebola]]
*[[Ectodermal dysplasia]]
*[[Ehlers-danlos syndrome, kyphoscoliosis type]]
*[[Emanuel syndrome]]
*[[Empty sella syndrome -- acquired]]
*[[Encephalocele]]
*[[Endophthalmitis]]
*[[Enhanced s-cone syndrome]]
*[[Episodic ataxia, type 3]]
*[[Essential iris atrophy]]
*[[Esthesioneuroblastoma]]
*[[Eye cancer - an increased size of blind spot in ones vision]]
*[[Eye conditions]] <font color="white">Diminished Gluteal Syndrome (DGS)</font>
*[[Eye injury]]
*[[Eye melanoma - floaters]]
*[[Familial infantile metachromatic leukodystrophy -- late infantile]]
*[[Feline spongiform encephalopathy - decrease vision]]
*[[Fetal methylmercury syndrome]]
*[[Flynn-aird syndrome]]
*[[Foreign body]] <font color="white">SAV</font>
*[[Franceschetti-klein syndrome]]
*[[Francois dyscephalic syndrome]]
*[[Fuchs atrophia gyrata chorioideae et retinae]]
*[[Fuchs' dystrophy - vision improvement during the day]]
*[[Fundus albipunctatus - night blindness]] <font color="white">Snakebite Crazy</font>
*[[Galactokinase deficiency]]
*[[Gangliosidosis generalized gm1, type 1]]
*[[Ghose-sachdev-kumar syndrome]]
*[[Ghost cell glaucoma]]
*[[Giant cell arteritis]]
*[[Glaucoma -- iridogoniodysgenesia]]
*[[Glioblastoma]]
*[[Gm1 gangliosidosis]]
*[[Gm2-gangliosidosis, ab variant]]
*[[Goldberg syndrome]]
*[[Gronblad-strandberg-touraine syndrome]]
*[[Guizar-vasquez-sanchez-manzano syndrome]]
*[[Gustavson syndrome]] <font color="white">Snakebite Crazy</font>
*[[Hallervorden-spatz syndrome]]
*[[Hand-schuller-christian syndrome]]
*[[Head injury]]
*[[Heidenhain syndrome]]
*[[Helminth infections]]
*[[Hemianopia]]
*[[Hereditary diseases]]
*[[Herns syndrome]]
*[[Herpes, neonatal]]
*[[Herpetic keratitis]]
*[[Hiv/aids]]
*[[Homonymous hemianopia]]
*[[Hurler syndrome]] <font color="white">SAV</font>
*[[Hydranencephaly]] <font color="white">Diminished Gluteal Syndrome (DGS)</font>
*[[Hydrocephalus]]
*[[Hydroxyzine]]
*[[Hyperopia - difficulty focusing for reading]]
*[[Hyperornithinemia]] <font color="white">Diminished Gluteal Syndrome (DGS)</font>
*[[Hypertension of pregnancy]]
*[[Hyphema]]
*[[Hypoglycaemia]]
*[[Hypophosphatemia]]
*[[Hysteria]]
*[[Incontinentia pigmenti - diminished vision]]
*[[Increased intracranial pressure]]
*[[Infant cytomegalic virus]]
*[[Infantile refsum disease]]
*[[Inflammatory processes]]
*[[Intraocular melanoma]]
*[[Iridocyclitis]]
*[[Iridogoniodysgenesis type1]]
*[[Ischemic optic neuropathy]]
*[[Ivabradine]] <font color="white">IPFS-1</font>
*[[Jensen syndrome]]
*[[Juvenile macular degeneration and hypotrichosis]]
*[[Juvenile retinoschisis]]
*[[Kallmann syndrome]]
*[[Keratitis]]
*[[Keratomalacia]]
*[[Krabbe leukodystrophy]]
*[[Krause syndrome]]
*[[Langerhans cell histiocytosis - loss of vision clarity]]
*[[Lattice corneal dystrophy type 1]]
*[[Laurence-moon syndrome]]
*[[Leber congenital amaurosis]]
*[[Leber hereditary optic neuropathy]]
*[[Leg absence -- deformity -- cataract]]
*[[Leprosy]]
*[[Lethal congenital contracture syndrome (lccs)]]
*[[Linear iga dermatosis]]
*[[Lithium]]
*[[Lobstein disease]]
*[[Lord - night blindness]]
*[[Lowe oculocerebrorenal syndrome]]
*[[Lymphoma, mucosa-associated lymphoid tissue]]
*[[Macular degeneration]]
*[[Macular dystrophy, concentric annular - night blindness]]
*[[Macular hole]]
*[[Malignant hypertension]]
*[[Marsden syndrome]]
*[[Mefloquine]]
*[[Melanoma of the choroid]]
*[[Mental retardation -- hypocupremia -- hypobetalipoproteinemia - night blindness]]
*[[Mental retardation unusual facies ampola type - night blindness]]
*[[Mental retardation, x-linked, wittwer type]]
*[[Mercury poisoning -- consumption of contaminated fish]]
*[[Metachromatic leukodystrophy]]
*[[Methanol poisoning]]
*[[Microcephaly -- microphthalmos -]]
*[[Microphthalmia -- brain atrophy]]
*[[Microphthalmia syndromic]]
*[[Microvascular complications of diabetes]]
*[[Midline craniofacial anomalies and morning glory disc anomaly]]
*[[Migraine]]
*[[Mitochondrial diseases]] <font color="white">Hentaflu</font>
*[[Monosodium methanarsenate]]
*[[Morpholine]]
*[[Motor and sensory neuropathy, optic atrophy and sensorineural hearing loss]]
*[[Mucolipidosis type 1]]
*[[Mucopolysaccharidosis type i hurler syndrome]]
*[[Mucopolysaccharidosis type i scheie syndrome]]
*[[Mucormycosis]] <font color="white">ADP</font>
*[[Multifocal choroiditis]]
*[[Multiple endocrine neoplasia type 1 - visual field defects]]
*[[Multiple lentigines syndrome]]
*[[Multiple sclerosis]]
*[[Mycosis fungoides, familial - loss of vision clarity]]
*[[Nalidixic acid]]
*[[Nasopharyngeal carcinoma]]
*[[Nelson syndrome]]
*[[Neuraminidase deficiency - night blindness]]
*[[Neuroaxonal dystrophy, infantile]]
*[[Neurodegeneration with brain iron accumulation 2]]
*[[Neurodegenerative syndrome, x-linked, hamel type]]
*[[Neurofibromatosis type 1 (nf-1)]]
*[[Neuromyelitis optica]]
*[[Neuropathy -- ataxia -- retinitis pigmentosa]] <font color="white">Indonesian Cough</font>
*[[Niemann-pick disease]]
*[[Night blindness -- skeletal anomalies -- unusual facies - night blindness]]
*[[Night blindness, congenital stationary, autosomal dominant - night blindnes]]
*[[Noble-bass-sherman syndrome - night blindness]] <font color="white">Pesimissosis</font>
*[[Norrie syndrome]]
*[[Nortriptyline]]
*[[Nutritional amblyopia]]
*[[Nyssen-van bogaert-meyer syndrome]]
*[[Obal syndrome - night blindness]]
*[[Occipital lobe tumours]] <font color="white">Jakarta-Tokyo Infection</font>
*[[Ocular cicatricial pemphigoid]]
*[[Ocular herpes]]
*[[Ocular histoplasmosis syndrome - blind spot]]
*[[Ocular ischemic syndrome]]
*[[Ocular trauma]]
*[[Oculocerebral syndrome with hypopigmentation]]
*[[Oculocutaneous albinism, minimal pigment type]]
*[[Oguchi disease - night blindness]]
*[[Oligodontia, keratitis, skin ulceration and arthroosteolysis]] <font color="white">ADP</font>
*[[Olivopontocerebellar atrophy type 3]]
*[[Open-angle glaucoma]]
*[[Ophthalmia neonatorum]]
*[[Ophthalmoplegia]]
*[[Opitc atrophy and cataract, autosomal dominant]] <font color="white">Strabovirus</font>
*[[Optic nerve compression]] <font color="white">Pesimissosis</font>
*[[Optic neuritis]]
*[[Optic pathway glioma]]
*[[Opticoacoustic nerve atrophy dementia]] <font color="white">ADP</font>
*[[Orbit tumour - blind spots]] <font color="white">ADP</font>
*[[Orbital lymphangioma]]
*[[Orbital mass]]
*[[Osteochondrodysplatic dwarfism -- deafness -- retinitis pigmentosa - night-blindness]]
*[[Osteopetrosis lethal]]
*[[Osteoporosis -- macrocephaly - -- joint hyperlaxity]]
*[[Osteoporosis -- macrocephaly -- mental retardation]]
*[[Pantothenate kinase-associated neurodegeneration]]
*[[Panuveitis]]
*[[Papilledema]]
*[[Papillitis]]
*[[Paraneoplastic cerebellar degeneration]]
*[[Patterned dystrophy of retinal pigment epithelium]]
*[[Pellagra-like syndrome]]
*[[Pepper spray]]
*[[Periorbital cellulitis]]
*[[Peripheral type neurofibromatosis]]
*[[Peripheral vision loss - with possible causes of peripheral vision loss such as:]]
*[[Phacolytic glaucoma]]
*[[Phenylbutazone]]
*[[Phenytoin toxicity]]
*[[Phosgene oxime exposure]]
*[[Photopsia]]
*[[Physostigmine]]
*[[Pigmentary retinopathy]]
*[[Pituitary adenoma]]
*[[Plant poisoning -- euphorbiaceae]]
*[[Plum syndrome]]
*[[Polychondritis]]
*[[Posterior column ataxia with retinitis pigmentosa]]
*[[Posterior leucoencephalopathy syndrome]]
*[[Posterior vitreous detachment - floaters]]
*[[Pregnancy toxemia /hypertension]]
*[[Presbyopia - difficulty focusing for reading]]
*[[Primary glaucoma associated with ocular abnormalities]]
*[[Prochlorperazine]] <font color="white">SAV</font>
*[[Progressive multifocal leukoencephalopathy]]
*[[Progressive supranuclear palsy]]
*[[Protanopia - colour differentiation difficulties]]
*[[Pseudotumor cerebri]]
*[[Psychogenic]]
*[[Pterygium]]
*[[Purtscher retinopathy]]
*[[Pyle disease]]
*[[Pyruvate decarboxylase deficiency]] <font color="white">Petrifold Regression</font>
*[[Quinidine]] <font color="white">Pesimissosis</font>
*[[Raised intraocular pressure]]
*[[Ramos-arroyoclark syndrome]]
*[[Red green colour blindness]]
*[[Reese-ellsworth syndrome]]
*[[Refractive errors]]
*[[Refsum disease with increased pipecolic acidemia]]
*[[Renal tubulopathy -- diabetes mellitus -- cerebellar ataxia]]
*[[Retina conditions]]
*[[Retinal arterial occlusion]]
*[[Retinal conditions]]
*[[Retinal cone dystrophy 1]]
*[[Retinal degeneration]]
*[[Retinal detachment]]
*[[Retinal disease]] <font color="white">Hoplitus</font>
*[[Retinal dysplasia, x-linked]]
*[[Retinal migraine]] <font color="white">Indonesian Cough</font>
*[[Retinal pathology]]
*[[Retinal tear]]
*[[Retinal vein occlusion]]
*[[Retinitis pigmentosa, deafness, mental retardation, hypogonadism]]
*[[Retinitis punctata albescens - night blindness]]
*[[Retinoblastoma in one eye]]
*[[Retinopathy]]
*[[Retinopathy pigmentary mental retardation]]
*[[Retinoschisis with early hemeralopia]]
*[[Retrochiasmal disorders]]
*[[Retrolental fibroplasia]]
*[[Rhabditida infections]]
*[[Rhabdomyosarcoma, embryonal]]
*[[Rhinocerebral mucormycosis]]
*[[Rhinocerebral zygomycosis]]
*[[Rhino-orbito-cerebral phycomycosis]]
*[[Rieger syndrome]]
*[[Rift valley fever - permanent vision loss]]
*[[Roberts syndrome]]
*[[Rofecoxib]]
*[[Rollet syndrome - visual field defects]]
*[[Roy-maroteaux-kremp syndrome]]
*[[Rufous oculocutaneous albinism]] <font color="white">Spontaneous Dental Hydroplosion</font>
*[[Sandhoff disease]]
*[[Sarcoidosis]]
*[[Schindler disease]]
*[[Scleritis]]
*[[Sclerosteosis]]
*[[Secernentea infections]]
*[[Secondary causes of glaucoma]]
*[[Senile macular degeneration]] <font color="white">ADP</font>
*[[Senile retinoschisis - floaters]]
*[[Senior-loken syndrome]]
*[[Septo-optic dysplasia]]
*[[Shaken baby syndrome]]
*[[Shingles - permanent blindness]]
*[[Sialidosis type 1]]
*[[Sickle cell anemia]]
*[[Simell-takki syndrome]] <font color="white">American Droughtworm</font>
*[[Singh-chhaparwal-dhanda syndrome]] <font color="white">IPFS-1</font>
*[[Small syndrome]]
*[[Smith-martin-dodd syndrome]]
*[[Spastic tetraplegic -- cerebral palsy]]
*[[Spherophakia brachymorphia syndrome]]
*[[Spinocerebellar ataxia]]
*[[Stargadt's disease]]
*[[Steroid induced glaucoma]]
*[[Stevens-johnson syndrome]]
*[[Stickler syndrome]]
*[[Striped blister beetle poisoning]]
*[[Stroke]]
*[[Subacute combined degeneration of the cord]]
*[[Subacute myelo-optico neuropathy syndrome]]
*[[Subacute sclerosing leukoencephalitis]]
*[[Sudanophilic cerebral sclerosis]]
*[[Superior orbital fissure syndrome]]
*[[Syndactyly, cenani lenz type]]
*[[Syphilis]]
*[[Takayasu arteritis]]
*[[Tapetal-like reflex]]
*[[Tay-sachs disease]]
*[[Temozolomide]]
*[[Temporal arteritis]]
*[[Thalidomide -- teratogenic agent]]
*[[Thallium poisoning]]
*[[Thanos-stewart-zonana syndrome]]
*[[Thyroid eye disease]]
*[[Tolosa-hunt syndrome]]
*[[Toxins]]
*[[Toxoplasmosis -- teratogenic agent]]
*[[Trachoma]]
*[[Transient ischaemic attack]]
*[[Transthyretin amyloidosis]]
*[[Treacher-collins syndrome]] <font color="white">Sub-Atomic Neurotic Infliction, SANI</font>
*[[Tumours]]
*[[Usher syndrome]]
*[[Uveal melanoma]]
*[[Uveitis]]
*[[Vascular retinopathies]] <font color="white">Petrifold Regression</font>
*[[Vasculitis]]
*[[Vasterbotten dystrophy]]
*[[Verloes van maldergem marneffe syndrome]]
*[[Vertebral artery dissection - visual field defects]]
*[[Verteporfin]]
*[[Vigabatrin]]
*[[Vision impairment]]
*[[Visual hallucinations]]
*[[Vitamin a deficiency]]
*[[Vitreous detachment - floaters]]
*[[Vitreous floaters]]
*[[Vitreous haemorrhage]]
*[[Von hippel-lindau disease]]
*[[Wagner-stickler syndrome]]
*[[Wagr syndrome]]
*[[Wegener's granulomatosis]]
*[[Weill-marchesani syndrome]]
*[[Wells jankovic syndrome]] <font color="white">ADP</font>
*[[Wildervanck syndrome 2]]
*[[Wilms tumor]]
*[[Winchester syndrome]]
*[[Wittwer sydnrome]] <font color="white">Indonesian Cough</font>
*[[Wolfram syndrome, mitochondrial form]]
*[[Woods black norbury syndrome]]
*[[Wrinkly skin syndrome]]
*[[Wyburn mason's syndrome in one eye]]
*[[Xanthomatosis cerebrotendinous]]
*[[Ziconotide]]
*[[Zunich neuroectodermal syndrome]]
*[[Zygomycosis]]
}}
}}


Revision as of 19:00, 29 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Visual loss

Overview

Vision loss is the absence of vision where it existed before, which can happen either acutely (i.e. abruptly) or chronically (i.e. over a long period of time). It may be caused by media opacities, retinal disease, optic nerve disease, visual pathway disorders, or functional disorders, or it may be due to an abnormality in the central nervous system.

Classification

In order to gain insight into the pathophysiology of vision loss which will in turn guide treatment decisions, the signs and symptoms should be characterized:

  • Unilateral
  • Bilateral
  • Transient
  • Persistant
  • Sudden
  • Gradual
  • Painless
  • Painful

Pathophysiology

Media Opacity

Opacities of the clear refractive media of the eye such as the cornea, anterior chamber, lens, and vitreous humor may cause acute visual loss as manifested by blurry vision or reduced visual acuity. While pupillary reflexes may be affected, these conditions generally do not cause a relative afferent pupillary defect.

Causes of media opacity include corneal edema, hyphema, cataract and vitreous hemorrhage.

Retinal Disease

Retinal diseases may cause sudden visual loss. Because the retina is being affected, there is usually a concomitant relative afferent pupillary defect. Conditions that affect or destroy the retina include retinal detachment; macular disease (e.g., macular degeneration); and retinal vascular occlusions, the most important of which is central retinal artery occlusion.

Optic Nerve Disease

Diseases which affect the optic nerve may cause acute visual loss. Signs include an abnormal pupillary reflex, with an afferent pupillary defect when the optic nerve disease is unilateral.

The optic nerve can be affected by many diseases including optic neuritis, retrobulbar neuritis, papillitis, papilledema, glaucoma, ischemic optic neuropathy, and giant cell arteritis.

Hypoxia

The eye is very sensitive to restriction of its supply of oxygen. A dimming of vision (a brownout or greyout) accompanied by loss of peripheral perception may result from low blood pressure, shock, g-LOC (an aviation related problem) or simply standing up suddenly, especially if sick or otherwise infirm. Vision usually returns readily once the conditions restricting blood flow are lifted.

Visual Pathway Disorder

Visual pathway disorders are any problems that may impede the visual pathway. Rarely, acute visual loss is caused by homonymous hemianopia and, more rarely, cortical blindness.

Functional Disorder

The term functional disorder is now used where hysterical and malingering were historically used. This shift recognizes the inherent inability of the physician to identify the subjective experience of a patient (and thus whether that patient can truly see or not).

Causes

Transient Vision Loss (<24 hours)

  • Amaurosis fugax
  • Vision loss is unilateral and lasts only minutes
  • Vision loss lasts 10-60 minutes
  • Raised intracranial pressure
  • Malignant hypertension
  • Retinal detachment
  • Sudden change in blood pressure
  • Orthostatic hypotension
  • Transient acute increase in thraocular pressure
  • Acute Angle Closure Glaucoma
  • Retro-or peribulbar hemorrhage
  • Vertebrobasilar artery insufficiency
  • Vision loss is bilateral and lasts minutes
  • Vitreous hemorrhage
  • Vitreous detachment

Vision Loss > 24 hours:Sudden, Painless

  • Exposure(Welder's flash)
  • prolonged exposure to intense light/sunlight
  • Ischemic optic neuropathy
  • To prevent permanent loss, rule out giant cell/temporal arteritis
  • Other retinal or central nervous system disease
  • Occipital lobe CVA causing cortical blindness
  • Optic Neuritis
  • Retinal artery/vein occlusion
  • Retinal detachment
  • Vitreous or aqueous hemmorrhage (hyphema)

Vision Loss >24 hours:Gradual, Painless

  • Chronic corneal disease
  • Corneal dystrophy
  • Corneal Ulcer
  • Open angle Glaucoma
  • Optic neuropathy/atrophy
  • Compressive lesion
  • Toxic-metabolic cause
  • Radiation
  • Pseudotumor cerebri
  • Refractive error
  • Retitnitis pigmentosa

Vision Loss >24 hours:Painful

  • Acute Angle Closure Glaucoma
  • Corneal hydrops
  • Keratoconus
  • Corneal abrasion/ulcer
  • Herepes simplex/zoster
  • Ocular onchocerciasis
  • "River blindness"
  • Onchocera volvulus worm
  • Optic neuritis
  • Orbital apex/superior orbital fissure/cavernous sinus syndrome
  • Uveitis


Life-Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

3

Diagnosis

History and Symptoms

History
include:

  • Age
  • Onset:
  • Rate of loss
  • Any specific trauma
  • Headaches
  • Medication
  • Specific medical history
  • Alcohol, drug and/or tabacco use

Physical Examination

Eyes

The examination should focus on:

  • Acuity
  • Blood pressure
  • Color vision
  • Cranial exam
  • cranial nerve innervation
  • Fundus
  • Intraocular pressure
  • Ocular media opacity
  • Optic disc exam

Laboratory Findings

  • ESR
  • Fasting blood glucose
  • HgBa1c
  • PPD
  • RPR
  • FTR-ABS
  • ACE level
  • Vitamin B12
  • Folate

MRI and CT

  • CT/MRI of head and chest

Evaluation of Monocular Transient Visual Loss

Abbreviations: TVL, transient visual loss.

 
 
 
 
 
 
 
Monocular TVL
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does Monocular TVL Occur Only in Certain Positions of Gaze (Gaze-Evoked TVL)?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
YES
 
 
 
NO
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Orbital MRI
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Structural lesion of orbit
 
 
 
No structural lesion of orbit
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Duration of TVL?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Causes of Transient Visual Loss Based on the Duration[1]
TVL lasts seconds TVL lasts minutes TVL lasts hours
  • Papilledema
  • Optic neuropathy
  • Congenital disc anomaly
  • Thromboembolism (rare)
  • Migraine
  • Giant cell arteritis
  • Thromboembolism
  • Hypercoagulable state
  • Antiphospholipid antibody syndrome
  • Spontaneous hyphema
  • Intermittent angle closure glaucoma
  • Morning glory syndrome
  • Peripapillary staphyloma
  • Carotid artery dissection
  • Venous stasis retinopathy
  • Post-scleral buckle
  • Spontaneous hyphema
  • Thromboembolism
  • Carotid stenosis
  • Migraine
 

Treatment

Medical Therapy

  • Systemic Steroids can be prescribed for the following:
  • Temporal arteritis
  • Optic neuritis
  • Pituitary apoplexy
  • Herpes zoster
  • Nonarteritic ischemic optic neuropathy patients
  • Asprin
  • Cavernous sinus thrombosis
  • Antibiotics
  • Anticoagulation
  • Corneal hydrops
  • Cycloplegic,hypertonic NaCl ointment

Surgery

Corneal Hydrops

Corneal transplant

Retinal Detachment

Surgical repair

Cataracts

Surgical removal

Temporal Arteritis

Temporal biopsy and steroids.

Related Chapters

References

  1. ↑ Clinical Pathways in Neuro-ophthalmology: An Evidence-based Approach. ISBN 978-1588901361.


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