Differential Diagnosis for Bilateral Loss of Peripheral Vision
Single Most Likely Diagnosis
- Glaucoma: A leading cause of irreversible blindness, glaucoma often presents with gradual, painless loss of peripheral vision in both eyes due to increased intraocular pressure damaging the optic nerve.
Other Likely Diagnoses
- Pituitary Tumors: Tumors in the pituitary gland can compress the optic chiasm, leading to bitemporal hemianopia, which may initially be perceived as a loss of peripheral vision.
- Retinitis Pigmentosa: A group of genetic disorders affecting the retina's ability to respond to light, leading to progressive vision loss, often starting with night blindness and peripheral vision loss.
- Diabetic Retinopathy: Advanced stages can cause significant vision problems, including loss of peripheral vision, due to damage to the blood vessels in the retina.
Do Not Miss Diagnoses
- Brain Tumors: Although less common, tumors in specific areas of the brain can cause visual field defects, including loss of peripheral vision. Early detection is crucial for treatment and prognosis.
- Stroke or Cerebrovascular Accidents: Visual field defects, including loss of peripheral vision, can occur due to ischemia or hemorrhage in areas of the brain responsible for vision processing.
- Multiple Sclerosis: An autoimmune disease that can affect any part of the central nervous system, including the optic nerves, leading to a variety of visual disturbances, including loss of peripheral vision.
Rare Diagnoses
- Choroideremia: A rare inherited disorder that causes progressive loss of the choroid, retina, and retinal pigment epithelium, leading to night blindness and loss of peripheral vision.
- Bassen-Kornzweig Syndrome (Abetalipoproteinemia): A rare inherited disorder affecting fat absorption and leading to vitamin deficiencies, which can cause retinal degeneration and loss of peripheral vision.
- Neurosyphilis: A complication of late or tertiary syphilis infection, which can cause a variety of neurological problems, including visual disturbances such as loss of peripheral vision.