Loss of vision DDx

Overview

Causes of visual loss or blindness can be categorised by presence or absence of trauma, transient or persistent and monocular or binocular.

Causes

 Nontraumatic causes of transient (<24h) monocular vision loss

Common causes of non-traumatic transient visual loss include:

  • amaurosis fugax (usually minutes) — usually embolic or thrombotic; can occur secondary to hypoperfusion states, hyperviscosity or vasospasm.
  • migraine (can be without headache)
  • one eye closed!

Uncommon causes include:

Nontraumatic causes of acute persistent monocular vision loss

Painless acute persistent loss of vision:

Painful acute loss of vision:

Nontraumatic causes of acute binocular loss of vision

Transient

  • migraine
  • vertebrobasilar insufficiency (transient)

Prolonged

  • Stroke
  • poisons/ toxic optic neuropathy (e.g. methanol, quinine, ethambutol, ergot alkaloids, salicylates)
  • posterior reversible encephalopathy (PRES)
  • optic or retrobulbar neuritis
  • hysteria
  • malingering

Post-traumatic causes of loss of vision

From ‘front to back’:


CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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