Differential Diagnosis for Blurry Vision

Given that a cerebrovascular accident (CVA) has been ruled out, the differential diagnosis for blurry vision can be categorized as follows:

• Single Most Likely Diagnosis

  • Refractive Error: This includes conditions such as myopia, hyperopia, astigmatism, and presbyopia. These are common causes of blurry vision and can be easily diagnosed with a vision test and corrected with glasses, contact lenses, or refractive surgery. The justification for this being the single most likely diagnosis is its high prevalence in the general population.

• Other Likely Diagnoses

  • Dry Eye Syndrome: This condition can cause blurry vision due to insufficient lubrication of the eyes. It's a common condition, especially in older adults, and can be diagnosed with a slit-lamp examination and treated with artificial tears.
  • Cataracts: Clouding of the lens in the eye that affects vision, causing blurry vision. It's a common condition in older adults and can be diagnosed with a slit-lamp examination. Treatment involves surgical removal of the cataract.
  • Glaucoma: A group of eye conditions that damage the optic nerve, often due to abnormally high pressure in the eye. It can cause blurry vision and is a common cause of blindness. Diagnosis is through measurement of intraocular pressure and visual field testing.
  • Macular Degeneration: A condition that causes loss of central vision due to damage to the macula. It's a common cause of vision loss in older adults and can be diagnosed with a fundoscopic examination.

• Do Not Miss Diagnoses

  • Giant Cell Arteritis: An inflammation of the arteries that can cause sudden blindness if not treated promptly. It's less common but critical to diagnose early through clinical presentation, elevated erythrocyte sedimentation rate (ESR), and biopsy of the temporal artery.
  • Optic Neuritis: Inflammation of the optic nerve that can cause blurry vision, often associated with multiple sclerosis. It's important to diagnose through clinical presentation, visual field testing, and MRI of the brain and orbits.
  • Diabetic Retinopathy: A complication of diabetes that can cause blurry vision due to damage to the blood vessels in the retina. It's crucial to diagnose through fundoscopic examination and treat to prevent progression.

• Rare Diagnoses

  • Multiple Sclerosis: An autoimmune disease that can affect the optic nerve and cause blurry vision. Diagnosis involves clinical presentation, MRI of the brain and orbits, and sometimes lumbar puncture.
  • Optic Neuropathy: Damage to the optic nerve that can cause blurry vision, which can be due to various causes including trauma, toxins, and infections. Diagnosis involves clinical presentation, visual field testing, and sometimes MRI.
  • Pituitary Tumors: Tumors in the pituitary gland can compress the optic chiasm and cause blurry vision. Diagnosis involves MRI of the brain and endocrine testing.