What is the most likely cause of recurrent unilateral blurred vision and eye pain in a patient with a history of major depressive disorder and generalized anxiety disorder?

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Differential Diagnosis

  • Single most likely diagnosis
    • C) Ocular migraine: This is the most likely explanation for the patient's symptoms, given the history of similar episodes, blurred vision, and mild pain in one eye. Ocular migraines can cause transient visual disturbances, including blurred vision, and are often accompanied by mild pain.
  • Other Likely diagnoses
    • A) Functional neurologic disorder: Although less likely, a functional neurologic disorder could be considered, given the patient's history of major depressive disorder and generalized anxiety disorder. However, the specific symptoms of blurred vision and pain in one eye are more suggestive of an ocular migraine.
    • F) Somatic symptom disorder: This diagnosis could be considered, given the patient's history of anxiety and depressive disorders, but the specific symptoms and history of similar episodes make ocular migraine a more likely explanation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • D) Optic neuritis: Although less likely, optic neuritis is a serious condition that can cause vision loss and pain in one eye. It is essential to consider this diagnosis, especially given the patient's symptoms of blurred vision and pain in one eye. Optic neuritis can be a manifestation of multiple sclerosis or other underlying conditions.
  • Rare diagnoses
    • B) Illness anxiety disorder: This diagnosis is less likely, as the patient's symptoms are more specific and suggestive of an ocular migraine. Illness anxiety disorder typically involves excessive worry about having a serious illness, which is not the primary concern in this case.
    • E) Panic attack: While the patient appears distressed, the symptoms described are not typical of a panic attack, which usually involves intense fear, palpitations, and shortness of breath. The patient's oxygen saturation is 99% on room air, and vital signs are within normal limits, making a panic attack less likely.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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