Loss of vision can be a scary symptom for patients to experience, and a scary presentation for doctors to manage! You will not be expected to know the causes in detail. However, some knowledge of the following conditions will help you to risk-stratify patients. These patients will most likely require an urgent referral to your ophthalmology colleagues for advice or review.
It is helpful to split the causes of sudden visual loss into painful and painless.
The table below highlights some of the more common causes of sudden visual loss:
Giant cell arteritis
Acute angle-closure glaucoma
Migraine / retinal migraine
|Central retinal artery obstruction|
Central retinal vein obstruction
History: A detailed history can help to distinguish between these causes. As well as ascertaining the degree and pattern of visual loss, it is always useful to ask about symptoms such as pain, red eye, flashes/floaters and photophobia. Many ophthalmological conditions are associated with systemic conditions, and so a thorough review of symptoms can be key.
Examination: You will not be expected to perform a comprehensive eye examination as that involves things like using a slit lamp to visualise the anterior and posterior chambers of the eye. However, examinations such as testing visual acuity and fundoscopy are easy to perform and give vital information to you when referring or speaking to the ophthalmology team. When performing fundoscopy, always try to dilate the eyes before; otherwise, it will be challenging to visualise the retina.
Below is an overview of some of the more common causes of visual loss. This is by no means comprehensive but aims to highlight some key points to know for each condition.
Painful, sudden visual loss
Painless, sudden visual loss
Written by Dr Tajwar Nasir (FY3)
Reviewed by Byron Lu Morrell (ST2 Ophthalmology)
Edited by Mudassar Khan (Y3 Medical Student)
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