Acute visual loss

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Acute visual loss
Other namesAcute vision loss
Snellen chart: rows of uppercase letters, the top row contains a very large 'E' and the size of the letters decreases with each row that follows.
A Snellen chart, which is frequently used for visual acuity testing

Acute visual loss is a rapid loss of the ability to see. It is caused by many ocular conditions like retinal detachment, glaucoma, macular degeneration, and giant cell arteritis, etc.

Video explanation (script)[1]

Main causes

Retinal detachment

Retinal detachment should be considered if there were preceding flashes or floaters, or if there is a new visual field defect in one eye.[2][3] If treated early enough, retinal tear and detachment can have a good outcome.[2]

Glaucoma

Angle-closure glaucoma should be considered if there is painful loss of vision with a red eye, nausea or vomiting.[4] The eye pressure will be very high typically greater than 40 mmHg.[5] Emergent laser treatment to the iris may prevent blindness.[4]

Macular degeneration

Wet macular degeneration should be considered in older people with new distortion of their vision with bleeding in the macula.[6][7] Vision can often be regained with prompt eye injections with anti-VEGF agents.[6]

Giant cell arteritis

Giant cell arteritis should be considered in an older person with jaw claudication, temporal pain, and tiredness.[8] Placing the person on steroids might save both their vision and decrease their risk of stroke.[9] Without treatment a person can quickly go blind in both eyes.[10]

Vascular occlusions

Vitreous hemorrhage

It is one of the most common causes of acute or subacute decrease in vision. [15]

Hyphema

Blood in the anterior chamber of the eye is known as hyphema. Severe hyphema covering pupillary area can cause sudden decrease in vision.

References

  1. ^ "Acute Visual Loss - MEDSKL". medskl.com. Retrieved 23 January 2019. (Video's script with inline references)
  2. ^ a b Fraser, S; Steel, D (24 November 2010). "Retinal detachment". BMJ Clinical Evidence. 2010. PMC 3275330. PMID 21406128.
  3. ^ "Facts About Retinal Detachment". National Eye Institute. October 2009. Archived from the original on 28 July 2016. Retrieved 26 July 2016.
  4. ^ a b "Facts About Glaucoma". National Eye Institute. Archived from the original on 28 March 2016. Retrieved 29 March 2016.
  5. ^ Simcock, Peter; Burger, Andre (2015). Fast Facts: Ophthalmology. Karger Medical and Scientific Publishers. p. 25. ISBN 9781908541727.
  6. ^ a b "Facts About Age-Related Macular Degeneration". National Eye Institute. June 2015. Archived from the original on 22 December 2015. Retrieved 21 December 2015.
  7. ^ Brown, Thomas Andrew; Shah, Sonali J. (2013). USMLE Step 1 Secrets3: USMLE Step 1 Secrets. Elsevier Health Sciences. p. 576. ISBN 978-0323085144.
  8. ^ "Giant Cell Arteritis". National Institute of Arthritis and Musculoskeletal and Skin Diseases. 13 April 2017. Archived from the original on 22 October 2017. Retrieved 21 October 2017.
  9. ^ "Giant Cell Arteritis". National Institute of Arthritis and Musculoskeletal and Skin Diseases. 13 April 2017. Retrieved 19 October 2018.
  10. ^ Solomon, Caren G.; Weyand, Cornelia M.; Goronzy, Jörg J. (2014). "Giant-Cell Arteritis and Polymyalgia Rheumatica". New England Journal of Medicine. 371 (1): 50–7. doi:10.1056/NEJMcp1214825. PMC 4277693. PMID 24988557.
  11. ^ Varma DD, Cugati S, Lee AW, Chen CS (June 2013). "A review of central retinal artery occlusion: clinical presentation and management". Eye. 27 (6): 688–97. doi:10.1038/eye.2013.25. PMC 3682348. PMID 23470793.
  12. ^ "Eye Strokes: CRAO, BRVO And Other Retinal Artery And Vein Occlusions".
  13. ^ Musa Abdelaziz, MD, Mahdi Rostamizadeh, Baseer Ahmad, MD. "Branch retinal vein occlusion".{{cite web}}: CS1 maint: multiple names: authors list (link)
  14. ^ Matthew Santos, Robert H. Janigian, Jr. M.D. "Branch retinal artery occlusion".{{cite web}}: CS1 maint: multiple names: authors list (link)
  15. ^ John P. Berdahl, MD, and Prithvi Mruthyunjaya, MD (March 2007). "Vitreous Hemorrhage: Diagnosis and Treatment".{{cite web}}: CS1 maint: multiple names: authors list (link)