Differential Diagnosis for Acute Monocular Painless Blurring of Vision with Linear Visual Defects
- Single Most Likely Diagnosis
- Central Retinal Vein Occlusion (CRVO) or Branch Retinal Vein Occlusion (BRVO): These conditions often present with sudden, painless vision loss in one eye, which can include linear visual defects due to the retinal hemorrhages and edema caused by the occlusion.
- Other Likely Diagnoses
- Retinal Detachment: Although it can be painful due to associated retinal tears, some cases may be painless. It presents with sudden onset of floaters, flashes of light, and a curtain or shadow descending over the field of vision, which can be described as linear visual defects.
- Macular Hole: A small break in the macula, which can cause distorted and blurred vision, including the perception of linear defects in the visual field.
- Epiretinal Membrane (Macular Pucker): This condition can cause blurred vision and visual distortion, including metamorphopsia (distorted vision), which might be perceived as linear defects.
- Do Not Miss Diagnoses
- Giant Cell Arteritis: Although it typically presents with pain, especially headache, jaw claudication, and scalp tenderness, some cases can be painless. It's crucial to consider this diagnosis due to its potential for rapid progression to bilateral blindness if not promptly treated.
- Optic Neuritis: Often presents with painful vision loss, but some cases can be painless. It's a critical diagnosis to consider due to its association with multiple sclerosis and the potential for significant visual impairment.
- Rare Diagnoses
- Ocular Migraine: Some types of migraines can cause visual auras without headache, including fortification spectra (teichopsia) that might be perceived as linear visual defects.
- Intraocular Lymphoma: A rare condition that can cause floaters, blurred vision, and visual field defects, including linear defects, due to infiltration of the retina or vitreous by lymphoma cells.
- Sarcoidosis: Can cause uveitis, which might lead to visual disturbances including blurring of vision and visual field defects, though linear defects are less common.