Differential Diagnosis for Sudden Onset of Partial Blindness

• Single most likely diagnosis:
  • Retinal Detachment: This condition often presents with sudden onset of partial blindness, especially if the detachment affects the macula or a significant portion of the retina. Symptoms can include flashes of light, floaters, and a curtain or shadow descending over the field of vision.
• Other Likely diagnoses:
  • Retinal Vein Occlusion: This condition can cause sudden vision loss in one eye due to a blockage of the veins that carry blood away from the retina. Risk factors include hypertension, diabetes, and glaucoma.
  • Optic Neuritis: Inflammation of the optic nerve can lead to sudden vision loss, often accompanied by pain on eye movement. It's more common in young adults and can be associated with multiple sclerosis.
  • Central Retinal Artery Occlusion: A blockage of the central retinal artery can cause sudden, painless loss of vision in one eye. It's a medical emergency requiring immediate attention.
• Do Not Miss diagnoses:
  • Giant Cell Arteritis: Although less common, this condition can cause sudden blindness in one or both eyes if the arteries supplying the optic nerves are affected. It's crucial to consider this diagnosis, especially in patients over 50, as prompt treatment with corticosteroids can prevent further vision loss.
  • Stroke or Cerebrovascular Accident: A stroke affecting the visual pathways in the brain can cause sudden blindness or visual field defects. Immediate recognition and treatment are critical to minimize brain damage.
• Rare diagnoses:
  • Ocular Migraine: Some types of migraines can cause transient blindness or visual disturbances, including partial blindness. However, these are usually reversible and may be accompanied by headache and other migraine symptoms.
  • Intraocular Tumors: Rarely, tumors within the eye, such as melanoma, can cause sudden vision changes, including partial blindness, by obstructing light or causing retinal detachment.