Acute Visual Loss

Table of Contents

• Media Opacities
• Vitreous Hemorrhage
  • Retinal Detachment (RD)
• Retinal Vascular Occlusion
  • Retinal Vein Occlusion
    • Central Retinal Vein Occlusion
    • Inferior Macular Lesion
  • Central Retinal Artery Occlusion
  • Branch Retinal Artery Occlusion
  • HemiRetinal Artery Occlusion
• Optic Nerve Disease
  • Optic Neuritis
• Visual Pathway Disorders
  • Cortical Blindness
• Functional Disorders

Acute Visual Loss

Overview

Definition

• Sudden onset of blindness.

• A disaster for most people and you should be able to evaluate such a patient and be able to recognize situations requiring urgent action.

Causes of Acute Visual Loss

Painful

• Acute Angle Closure Glaucoma - Narrow angle Glaucoma
  • Female - mid dilated pupil
• Uveitis
• Keratitis
• Corneal Abrasion and Eye Trauma
• Endophthalmitis

Painless

• Vitreous Hemorrhage
• Retinal Detachment RD
• Retinal Vascular Occlusions
• Optic Neuritis
• Ischemic Optic Neuropathy
• Cerebrovascular Accident (CVA)
  • Stroke*
• Functional

Secondary to

1. Media Opacities
2. Retinal Disease
3. Optic Nerve Disease
4. Visual Pathway Disorders
5. Functional Disorders
6. Acute Discovery of Chronic Visual Loss

History

The history questions to be asked of a patient with sudden visual loss include:

1. Is the visual loss transient, persistent, or progressive?
2. Is the visual loss monocular or binocular?
3. Did the visual loss occur suddenly or did it develop over hours, days, or weeks?
4. What is the patient’s age and general medical condition?
5. Did the patient have normal vision in the past and when was vision last tested?
6. Was pain associated with the visual loss?

1 - Ask about trauma

Examination

• Visual Acuity Testing
• Confrontation Visual Fields unilateral
• Pupillary Reactions Afferent Pupillary Defect
• Ophthalmoscopy vascular optic neuritis RD
• External Examination of the Eye with a Pen Light
• Tonometry to Measure the Intraocular Pressure

Eye Conditions and Images