Differential Diagnosis for Visual Disturbance in an 8-month-old Male Infant

• Single most likely diagnosis
  • Retinopathy of prematurity (ROP): This condition is a leading cause of childhood blindness and is highly associated with preterm birth, especially in infants born before 31 weeks of gestation. The infant's history of being born at 28 weeks' gestation increases the risk for ROP, which can cause visual disturbances due to abnormal blood vessel growth in the retina.
• Other Likely diagnoses
  • Strabismus: Although not as directly related to prematurity as ROP, strabismus (crossed eyes) can lead to vision problems, including difficulty with depth perception and grasping objects. It's a common condition in children and can be more prevalent in preterm infants.
  • Cataract: Congenital cataracts can cause significant visual impairment and are more common in preterm infants. However, they are less likely than ROP in this context but still a consideration.
• Do Not Miss diagnoses
  • Glaucoma: Although less common, congenital glaucoma can cause significant vision problems and is a condition that would have severe consequences if missed. It's characterized by increased intraocular pressure and can lead to corneal edema, photophobia, and vision loss.
• Rare diagnoses
  • Blockage of the scleral venous sinus: This condition is less common and would be an unusual cause of visual disturbance in an infant. It could potentially lead to secondary glaucoma or other ocular complications but is not as directly associated with prematurity or the symptoms described.