Differential Diagnosis for Black Floaters and Limited Vision

• Single most likely diagnosis
  • Retinal detachment: This condition is characterized by the separation of the retina from the underlying tissue, which can cause sudden appearance of black floaters and vision loss. The symptom of seeing light only suggests a significant visual impairment, which aligns with the potential severity of retinal detachment.
• Other Likely diagnoses
  • Vitreous hemorrhage: Bleeding into the vitreous humor can cause sudden onset of black floaters and decreased vision, including the ability to see light only. This condition often results from trauma, diabetes, or retinal tears.
  • Posterior vitreous detachment (PVD): While typically less severe than retinal detachment, PVD can cause floaters due to the vitreous gel pulling away from the retina. However, significant vision loss, such as seeing light only, is less common but possible in severe cases.
• Do Not Miss diagnoses
  • Central retinal artery occlusion: Although less common, this condition is an ophthalmologic emergency. It involves blockage of the central retinal artery, leading to sudden, severe vision loss, which could be described as seeing light only. Prompt treatment is necessary to attempt to restore vision.
  • Central retinal vein occlusion: Similar to central retinal artery occlusion, this is a vascular emergency that can cause sudden vision loss. It involves blockage of the central retinal vein and requires immediate medical attention.
• Rare diagnoses
  • Ocular migraine: Some types of migraines can cause visual disturbances, including floaters and significant vision loss. However, seeing light only would be an unusual presentation.
  • Choroidal melanoma: A rare type of eye cancer that can cause visual disturbances, including floaters, if it affects the retina or vitreous. Significant vision loss could occur in advanced stages.
  • Intraocular inflammation (uveitis): Severe cases of uveitis can lead to significant vision loss and floaters, but seeing light only would be an uncommon initial presentation.