Differential Diagnosis for a 72-year-old Female with Floaters and Scotoma of the Left Eye for 2 Days
- Single most likely diagnosis:
- Retinal Detachment: This condition is characterized by the separation of the retina from the underlying tissue, often presenting with sudden onset of floaters and scotoma. The patient's age and symptoms make this a highly plausible diagnosis.
- Other Likely diagnoses:
- Posterior Vitreous Detachment (PVD): A common condition in older adults where the vitreous gel separates from the retina, causing floaters and occasionally scotoma.
- Retinal Vein Occlusion: A blockage of the small veins that carry blood away from the retina, which can cause sudden vision loss and scotoma.
- Macular Hole: A small break in the macula, which can cause distorted and blurred vision, including scotoma.
- Do Not Miss diagnoses:
- Central Retinal Artery Occlusion: A blockage of the central retinal artery, which supplies blood to the retina, leading to sudden and severe vision loss. Although less common, missing this diagnosis can result in permanent vision loss.
- Giant Cell Arteritis: An inflammation of the blood vessels, which can cause vision loss and other systemic symptoms. Prompt diagnosis and treatment are crucial to prevent permanent vision loss.
- Rare diagnoses:
- Ocular Migraine: A condition characterized by recurrent episodes of transient visual symptoms, including scotoma, often accompanied by headache.
- Choroidal Melanoma: A rare type of eye cancer that can cause vision loss and other symptoms, including floaters and scotoma.
- Intraocular Inflammation (Uveitis): Inflammation of the uvea, which can cause a range of symptoms, including floaters, scotoma, and vision loss.