Differential Diagnosis for Vision Loss
Single Most Likely Diagnosis
- Age-related Macular Degeneration (AMD): This is a leading cause of vision loss in older adults, characterized by the deterioration of the macula, which is the part of the retina responsible for sharp, central vision. The likelihood of AMD increases with age, smoking, and family history.
Other Likely Diagnoses
- Diabetic Retinopathy: A common complication of diabetes, leading to vision loss due to damage to the blood vessels in the retina. The risk increases with the duration of diabetes and the level of blood sugar control.
- Glaucoma: A group of eye conditions that damage the optic nerve, often due to abnormally high pressure in the eye. It's a common cause of vision loss, especially in older adults, and can be asymptomatic in its early stages.
- Cataracts: Clouding of the lens in the eye that affects vision, commonly age-related but can also be caused by trauma, certain medications, or systemic diseases.
- Refractive Errors: Conditions like myopia (nearsightedness), hyperopia (farsightedness), and astigmatism can cause significant vision loss if not corrected with glasses, contact lenses, or surgery.
Do Not Miss Diagnoses
- Giant Cell Arteritis: An inflammatory disease of the blood vessels that can lead to sudden and permanent vision loss if not promptly treated. It typically affects people over 50 and can also cause headaches and jaw pain.
- Retinal Detachment: A medical emergency where the retina separates from the back of the eye, requiring immediate treatment to preserve vision.
- Endophthalmitis: A severe inflammation of the interior of the eye, usually caused by infection. It's a medical emergency that can result in vision loss if not promptly treated.
- Optic Neuritis: Inflammation of the optic nerve that can cause vision loss and is often associated with multiple sclerosis.
Rare Diagnoses
- Leber's Hereditary Optic Neuropathy (LHON): A rare inherited disease that causes sudden and irreversible vision loss in young adults, more commonly in males.
- Choroideremia: A rare genetic disorder that causes progressive loss of the choroid, retina, and retinal pigment epithelium, leading to blindness.
- Best Disease (Vitelliform Macular Dystrophy): A rare genetic eye disorder that causes progressive vision loss in childhood or early adulthood due to mutations in the BEST1 gene.
- Syphilis-Related Vision Loss: Vision loss can occur in the late stages of syphilis due to inflammation of various parts of the eye. It's rare but important to consider, especially in patients with a history of sexually transmitted infections.