Transient Monocular Vision loss - Differential Diagnosis
- Large artery disease (atherothrombosis, embolus, dissection).
- Small artery occlusive disease (anterior ischemic optic neuropathy, vasculitis)
Retinal vein occlusion - Associated with chronic glaucoma, atherosclerotic risk factors (age, DM, HTN), hyperviscosity, coagulopathy
Retinal vasospasm / retinal migraine - Poorly understood vasospasm of retinal artery, associated with migraine headaches. Generally reversible
Optic neuropathy - Patients with chronic optic neuropathy can have transient episodes of vision loss, usually with hot showers or exercise (inc body temp –Uhthoff’s phenomenon)
Papilledema - “whiting” or “graying out” of part or all of the visual field, usually positional. Caused by decreased nerve perfusion associated with increased ICP
Optic nerve compression - Provoked by changes in gaze/eye movement, assoc with compressive optic neuropathies from tumor, trauma, Graves.
Ocular causes - Increased intraocular pressure (angle closure glaucoma), anterior chamber hemorrhage, vitreous floaters obscuring central vision
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