Visual Loss

Visual Loss is a topic covered in the 5-Minute Emergency Consult.

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  • Decrease in visual function (i.e., visual acuity, visual fields, blurry vision)
  • Visual loss has many etiologies and can be caused by multiple body systems


  • Ophthalmologic:
    • Eyelid or tear film abnormality
    • Anterior segment (cornea, anterior chamber, iris, lens)
    • Posterior segment (vitreous, retina, optic nerve)
    • Posterior to the eye (optic nerve, chiasm, radiations)
  • Traumatic:
    • Corneal abrasion
    • Hyphema
    • Lens dislocation
    • Ruptured globe
    • Commotio retinae
    • Retinal detachment
    • Retinal/vitreous hemorrhage
    • Retrobulbar hemorrhage
    • Intraocular foreign body
  • Neurologic:
    • Cerebral (cerebrovascular accident [CVA]) or intracranial pathology (mass lesion)
    • Multiple sclerosis
    • Optic neuritis
    • Migraine
  • Cardiovascular system:
    • Embolic
    • Thrombotic
    • Ischemic
    • Hypertensive events
  • Immunologic system:
    • Uveitis
    • Giant cell arteritis
  • Infection:
    • Orbital cellulitis/abscess
    • Cavernous sinus thrombosis
    • HIV optic neuropathy or cytomegalovirus (CMV) retinitis
  • Endocrine:
    • Diabetic retinopathy
    • Thyroid disease may cause diplopia (muscle hypertrophy) or corneal erosions
  • Toxic:
    • Methanol (acute severe loss, subacute optic atrophy)
    • Licorice (transient loss, self-limited)
    • Digitalis (flashing lights, color changes)
    • Amiodarone (rare cause of optic neuropathy)

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