Differential Diagnosis for Sudden Onset of Unilateral Vision Loss
Single Most Likely Diagnosis
- Central Retinal Artery Occlusion (CRAO): This condition is characterized by the sudden blockage of the central retinal artery, leading to ischemia of the retina and resulting in sudden, painless, unilateral vision loss. It is a medical emergency requiring prompt treatment.
Other Likely Diagnoses
- Retinal Detachment: A condition where the retina separates from the back of the eye, causing sudden vision loss, often accompanied by flashes of light and floaters.
- Optic Neuritis: Inflammation of the optic nerve, which can cause sudden vision loss, pain on eye movement, and decreased color vision.
- Ischemic Optic Neuropathy: A condition caused by decreased blood flow to the optic nerve, leading to sudden vision loss, often in older adults.
Do Not Miss Diagnoses
- Giant Cell Arteritis: An inflammatory condition that can cause sudden vision loss if it affects the optic nerve or ophthalmic artery. It is crucial to diagnose and treat promptly to prevent further vision loss.
- Carotid Artery Dissection or Occlusion: A condition where the carotid artery is either blocked or torn, potentially leading to decreased blood flow to the eye and resulting in vision loss.
- Migraine with Aura: Although typically not permanent, a migraine with aura can cause transient, unilateral vision loss and is essential to differentiate from other more severe conditions.
Rare Diagnoses
- Ocular Malignant Hypertension: Severe, uncontrolled hypertension leading to vision loss due to retinal and optic nerve damage.
- Susac Syndrome: A rare condition characterized by microangiopathic changes in the brain, retina, and inner ear, leading to vision loss among other symptoms.
- Intraocular Tumors: Although rare, tumors within the eye can cause sudden vision loss if they obstruct the visual pathway or cause retinal detachment.