Differential Diagnosis for Sudden Onset Blurry Vision and Headache
Single Most Likely Diagnosis
- Papilledema (C): The patient's symptoms of sudden onset blurry vision, headache, and complete loss of vision, along with funduscopic evidence of swelling of the optic disc and peripheral blind spots bilaterally, are highly suggestive of papilledema. This condition is often associated with increased intracranial pressure, which can cause the optic disc swelling and transient vision loss.
Other Likely Diagnoses
- Glaucoma (B): The patient's high blood pressure and symptoms of blurry vision and headache could also suggest glaucoma, particularly acute angle-closure glaucoma. However, the presence of papilledema and peripheral blind spots makes this less likely.
- Retinal Vascular Occlusion (E): The patient's history of hypertension and hyperlipidemia increases the risk of retinal vascular occlusion, which can cause sudden vision loss. However, the bilateral nature of the symptoms and the presence of papilledema make this less likely.
Do Not Miss Diagnoses
- Retinal Detachment (D): Although less likely, retinal detachment is a medical emergency that requires prompt treatment to prevent permanent vision loss. The patient's symptoms of sudden onset blurry vision and headache could be consistent with retinal detachment, and it is essential to rule out this condition with a thorough eye examination.
- Giant Cell Arteritis: This condition can cause sudden vision loss and headache, particularly in older adults. Although not explicitly mentioned in the options, it is a critical "do not miss" diagnosis due to its potential for irreversible vision loss if not treated promptly.
Rare Diagnoses
- Cataracts (A): Cataracts typically cause gradual vision loss and are less likely to cause sudden onset blurry vision and headache.
- Other rare conditions: Such as optic neuritis, ischemic optic neuropathy, or cerebral venous sinus thrombosis, could also be considered, but are less likely given the patient's presentation and the presence of papilledema.