Differential Diagnosis for Positional Loss of Vision
- Single most likely diagnosis
- Giant Cell Arteritis: This condition is a common cause of positional loss of vision, particularly in older adults. It involves inflammation of the blood vessels, which can lead to transient vision loss, especially when changing positions.
- Other Likely diagnoses
- Vasovagal Syncope: A reflex of the involuntary nervous system that can cause a feeling of lightheadedness or fainting when standing up or changing positions, potentially leading to transient loss of vision.
- Orthostatic Hypotension: A sudden drop in blood pressure when standing up, which can cause dizziness, lightheadedness, and transient vision loss.
- Benign Paroxysmal Positional Vertigo (BPPV): A condition related to the inner ear that can cause brief, intense episodes of vertigo and potentially lead to positional vision disturbances.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Papilledema: Increased intracranial pressure can cause transient vision loss, especially when changing positions. Missing this diagnosis could lead to severe complications, including permanent vision loss or brain damage.
- Carotid Artery Stenosis or Dissection: Narrowing or tearing of the carotid artery can cause transient vision loss, especially when changing positions. Missing this diagnosis could lead to stroke or other severe complications.
- Migraine with Aura: Some migraines can cause transient vision loss, especially when changing positions. While not typically life-threatening, missing this diagnosis could lead to delayed treatment and increased risk of stroke.
- Rare diagnoses
- Vitreous Detachment: A condition where the vitreous gel in the eye separates from the retina, potentially causing floaters and transient vision disturbances when changing positions.
- Chiari Malformation: A rare structural defect in the brain that can cause increased intracranial pressure and lead to transient vision loss, especially when changing positions.
- Superior Semicircular Canal Dehiscence: A rare condition where a small opening in the bone above the inner ear canal can cause vertigo, hearing loss, and potentially lead to positional vision disturbances.