Differential Diagnosis for Acute Onset Painless Blurring of Vision with Expanding Black Holes
- Single Most Likely Diagnosis
- Central Serous Chorioretinopathy (CSC): This condition is characterized by the accumulation of fluid under the retina, leading to a detachment that can cause visual disturbances, including the perception of black holes or blind spots. The acute onset and painless nature of the symptoms, along with the specific visual disturbance described, make CSC a strong candidate for the diagnosis.
- Other Likely Diagnoses
- Macular Hole: A small break in the macula, which can cause distorted and blurred vision. The description of "expanding black holes" could be interpreted as the patient's perception of their visual field defect.
- Epiretinal Membrane: A condition where a layer of fibrous tissue forms on the surface of the retina, causing visual disturbances. While it might not directly cause "black holes," it can lead to significant visual symptoms.
- Do Not Miss Diagnoses
- Retinal Detachment: Although it often presents with flashes of light and floaters, in some cases, it can cause sudden painless loss of vision. Missing this diagnosis could lead to permanent vision loss if not promptly treated.
- Optic Neuritis: Inflammation of the optic nerve, which can cause painless loss of vision, especially in young adults. It's crucial to diagnose and treat to prevent long-term vision impairment.
- Rare Diagnoses
- Occipital Lobe Infarction: A stroke affecting the visual processing centers of the brain, which could potentially cause unusual visual disturbances, including the perception of black holes in the visual field.
- Migraine with Aura: Some migraine auras can cause significant visual disturbances, including blind spots or zigzag patterns, which might be perceived as "expanding black holes" by the patient. However, migraines typically have other associated symptoms like headache and are less likely to cause such specific and severe visual symptoms without other migraine features.