Differential Diagnosis for Visual Disturbance with Improvement by Closing One Eye

• Single most likely diagnosis:
  • Refractive error (e.g., myopia, hyperopia, astigmatism): This is the most common reason for visual disturbances that improve when one eye is closed, as it often indicates a difference in refractive power between the two eyes.
• Other Likely diagnoses:
  • Amblyopia: Also known as lazy eye, this condition can cause visual disturbances that might seem to improve when one eye is closed, especially if the amblyopia is in one eye.
  • Strabismus: Misalignment of the eyes can cause double vision or visual disturbances that may improve when one eye is closed.
  • Cataract: Especially if it's unilateral or significantly asymmetric, cataracts can cause visual disturbances that improve with monocular vision.
• Do Not Miss diagnoses:
  • Retinal detachment: Although less common, retinal detachment is a medical emergency that can cause sudden visual disturbances, including flashes of light and floaters, which might seem to improve when one eye is closed.
  • Glaucoma: Acute angle-closure glaucoma is an emergency that can cause severe visual disturbances, including halos around lights, which might temporarily seem better when one eye is closed.
  • Optic neuritis: Inflammation of the optic nerve can cause visual loss or disturbances that might seem to improve with monocular vision.
• Rare diagnoses:
  • Occipital lobe lesions: Rarely, lesions in the occipital lobe of the brain can cause visual field defects or disturbances that might seem to improve when one eye is closed, due to the complex processing of visual information.
  • Chiasmal lesions: Lesions affecting the optic chiasm can cause complex visual field defects, which might improve with monocular vision in some cases.