Differential Diagnosis for a 6-year-old Girl with Visual Disturbances
Single Most Likely Diagnosis
- Myopic retinal degeneration or myopia-related retinal changes: Given her history of myopia, the presence of dots and lines in her vision could be related to retinal changes associated with high myopia, such as retinal stretching or early signs of retinal degeneration.
Other Likely Diagnoses
- Floaters: Common in myopic individuals, floaters are small, shadowy spots that appear to float in front of the eyes due to vitreous gel changes. They can be perceived as dots or lines.
- Vitreous detachment: Although more common in older adults, myopic children can experience vitreous detachment, which might cause visual disturbances like seeing dots or lines.
- Refractive error changes: Changes in the refractive error of her eyes could lead to visual disturbances, including seeing dots or lines, especially if her glasses prescription is not up to date.
Do Not Miss Diagnoses
- Retinal tear or detachment: Although less likely, a retinal tear or detachment is a medical emergency that requires immediate attention. Symptoms can include sudden onset of floaters, flashes of light, or a curtain descending over the visual field.
- Diabetic retinopathy: Though rare in children without known diabetes, it's crucial to consider in any child presenting with visual disturbances, as untreated diabetic retinopathy can lead to severe vision loss.
- Intraocular tumors (e.g., retinoblastoma): Although rare, intraocular tumors can cause visual disturbances and are critical to diagnose early for effective treatment.
Rare Diagnoses
- Ocular migraine: Some individuals, including children, can experience ocular migraines that may cause visual disturbances like seeing dots or lines, usually with a headache.
- Sympathetic ophthalmia: A rare, inflammatory condition that can occur after penetrating eye injury, leading to visual disturbances in the unaffected eye.
- Toxocariasis: A parasitic infection that can cause ocular inflammation and visual disturbances, though it's more commonly associated with other symptoms like redness and pain.