Differential Diagnosis for Transient Vision Loss with Dilated Pupil after Eye Trauma
Single Most Likely Diagnosis
- Traumatic Iridocyclitis or Concussive Injury to the Eye: This is the most likely diagnosis given the history of receiving a ball in the eye, which can cause direct trauma to the iris, ciliary body, or other structures within the eye, leading to inflammation or concussive injury.
Other Likely Diagnoses
- Hyphema: Blood in the anterior chamber of the eye can occur after trauma, potentially causing vision loss and a dilated pupil due to irritation or increased intraocular pressure.
- Vitreous Hemorrhage: Trauma can cause bleeding into the vitreous humor, the gel-like substance inside the center of the eye, which may lead to sudden vision loss and could be associated with a dilated pupil.
- Commotio Retinae (Berlin's Edema): This condition, characterized by retinal edema caused by trauma, can lead to transient vision loss and might be associated with a dilated pupil due to the body's response to injury.
Do Not Miss Diagnoses
- Retinal Detachment: Although less common, retinal detachment is a serious condition that can result from eye trauma. It requires immediate medical attention to preserve vision, making it a critical diagnosis not to miss.
- Globe Rupture: A severe injury where there is a full-thickness wound through the eyewall (cornea or sclera), which is an emergency requiring immediate surgical intervention to save the eye.
- Optic Neuropathy: Trauma can cause damage to the optic nerve, potentially leading to vision loss. Early recognition and treatment may improve outcomes.
Rare Diagnoses
- Traumatic Cataract: While cataracts are common, they are less likely to occur immediately after trauma. However, significant force can cause lens damage leading to cataract formation.
- Choroidal Rupture: A break in the choroid, a layer of blood vessels between the sclera and retina, which can lead to vision loss and might be associated with other signs of trauma.
- Sympathetic Ophthalmia: A rare, inflammatory condition that can occur after penetrating eye injury, potentially affecting both the injured and the uninjured eye, leading to severe vision loss if not treated promptly.