Central Vision Loss Differential Diagnosis
The following differential diagnosis is organized into categories to help guide the thought process:
- Single Most Likely Diagnosis + Age-related macular degeneration (AMD): This is the most common cause of central vision loss in older adults, especially those over 50 years old. AMD is a degenerative condition that affects the macula, the part of the retina responsible for central vision.
- Other Likely Diagnoses + Diabetic macular edema: This condition occurs in people with diabetes and is caused by the accumulation of fluid in the macula, leading to central vision loss. + Macular hole: A small break in the macula that can cause central vision loss, often affecting one eye at a time. + Epiretinal membrane: A condition where a layer of fibrous tissue forms on the surface of the retina, causing central vision loss. + Central serous retinopathy: A condition characterized by the accumulation of fluid under the retina, leading to central vision loss.
- Do Not Miss Diagnoses + Optic neuritis: Inflammation of the optic nerve that can cause central vision loss, often associated with multiple sclerosis or other demyelinating diseases. + Pituitary tumor: A tumor that compresses the optic chiasm, causing central vision loss, especially if it affects both eyes. + Stroke or cerebral vasculitis: Conditions that can cause central vision loss due to damage to the visual pathways in the brain. + Syphilis: A bacterial infection that can cause central vision loss if left untreated, especially in its tertiary stage.
- Rare Diagnoses + Leber's hereditary optic neuropathy: A rare genetic disorder that causes central vision loss, typically affecting young adults. + Cone dystrophy: A group of rare genetic disorders that affect the cone cells in the retina, leading to central vision loss. + Choroidal osteoma: A rare benign tumor of the choroid layer of the eye that can cause central vision loss. + North Carolina macular dystrophy: A rare genetic disorder that causes central vision loss, typically affecting children and young adults.