Sarcoidosis: This condition is known for its multi-system involvement, including the lungs (causing pleural effusions and pulmonary infiltrates) and the eyes (potentially leading to blindness through uveitis or other mechanisms). Its systemic nature and the combination of respiratory and ocular symptoms make it a strong candidate.

Wegener's Granulomatosis (Granulomatosis with Polyangiitis): This autoimmune disorder can cause pulmonary infiltrates and pleural effusions due to its vasculitic nature. It can also lead to ocular symptoms, including blindness, through involvement of the eyes.
Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with pulmonary infiltrates and pleural effusions. Ocular involvement, though less common, can occur and lead to blindness, especially in the case of central nervous system lymphoma affecting the optic nerves.
Systemic Lupus Erythematosus (SLE): SLE is a systemic autoimmune disease that can affect multiple organs, including the lungs (causing pleural effusions and infiltrates) and the eyes (leading to blindness through various mechanisms like retinal vasculitis).

Tuberculosis: Although less likely to cause acute onset blindness directly, TB can cause pulmonary infiltrates and pleural effusions. In rare cases, it can also affect the eyes (e.g., tuberculous uveitis), making it a diagnosis not to be missed due to its treatability and potential severity.
Cancer with Metastasis: Certain cancers, especially those originating from the breast, lung, or gastrointestinal tract, can metastasize to both the lungs (causing infiltrates and effusions) and the eyes (potentially leading to blindness). Missing this diagnosis could significantly impact treatment and prognosis.
Viral or Bacterial Infections: Certain infections, such as viral pneumonias or bacterial sepsis, can lead to acute respiratory distress syndrome (ARDS) and, in rare cases, ocular complications. Identifying and treating these infections promptly is crucial.

Erdheim-Chester Disease: A rare form of histiocytosis that can affect multiple systems, including the lungs and eyes, potentially leading to the symptoms described.
Langerhans Cell Histiocytosis: Although more commonly associated with bone and pulmonary lesions, in rare cases, it can cause ocular symptoms and should be considered in the differential diagnosis due to its potential for multi-system involvement.
Churg-Strauss Syndrome: Now known as Eosinophilic Granulomatosis with Polyangiitis, this condition is characterized by asthma, eosinophilia, and vasculitis affecting multiple organs, including the lungs and potentially the eyes.