What are the causes of intermittent unilateral visual loss?

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Last updated: March 5, 2025View editorial policy

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Differential Diagnosis for Intermittent Unilateral Vision Loss

  • Single Most Likely Diagnosis
    • Giant Cell Arteritis (GCA): This condition is a common cause of intermittent unilateral vision loss, especially in older adults. It is characterized by inflammation of the medium and large arteries, which can lead to optic nerve ischemia and vision loss.
  • Other Likely Diagnoses
    • Carotid Artery Stenosis: Narrowing of the carotid artery can lead to decreased blood flow to the eye, causing intermittent vision loss. This condition is often associated with atherosclerosis.
    • Migraine: Migraines can cause transient visual symptoms, including unilateral vision loss, due to vasospasm or other mechanisms.
    • Optic Neuritis: Inflammation of the optic nerve can cause vision loss, which may be intermittent in some cases.
  • Do Not Miss Diagnoses
    • Central Retinal Artery Occlusion (CRAO): This is an ocular emergency that requires prompt treatment to prevent permanent vision loss. It is characterized by sudden, painless vision loss in one eye.
    • Retinal Detachment: A detached retina can cause vision loss, which may be intermittent if the detachment is partial.
    • Pituitary Apoplexy: Sudden hemorrhage or infarction of a pituitary tumor can cause vision loss, which may be intermittent.
  • Rare Diagnoses
    • Susac Syndrome: A rare condition characterized by microangiopathy of the retina, brain, and inner ear, which can cause intermittent vision loss.
    • Eale Disease: A rare condition characterized by retinal vasculitis and neovascularization, which can cause intermittent vision loss.
    • Vasculitis (e.g., Wegener's Granulomatosis): Systemic vasculitis can cause inflammation of the blood vessels supplying the eye, leading to intermittent vision loss.

Professional Medical Disclaimer

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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