Acute visual loss

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.

Acute visual loss
Other names	Acute vision loss
A Snellen chart, which is frequently used for visual acuity testing

Video explanation (script)^[1]

Main causes

Retinal detachment

Main article: 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

Main article: 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

Main article: 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

Main article: 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

• Central retinal artery occlusion: CRAO is characterized by painless, acute vision loss in one eye.^[11]
• Central retinal vein occlusion: CRVO causes sudden, painless vision loss that can be mild to severe. ^[12]
• Branch retinal vein occlusion: sudden painless vision loss or visual field defect are the main symptom of BRVO. ^[13]
• Branch retinal artery occlusion: BRAO may also cause acute painless loss of vision. ^[14]

Vitreous hemorrhage

Main article: Vitreous hemorrhage

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

Hyphema

Main article: 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. 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. from the original on 28 July 2016. Retrieved 26 July 2016.
4. "Facts About Glaucoma". National Eye Institute. 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. "Facts About Age-Related Macular Degeneration". National Eye Institute. June 2015. 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. 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)