Differential Diagnosis for Black Visual Floater without Eye Pain, Trauma, or Abnormal Finding on External Eye Exam
- Single Most Likely Diagnosis
- Vitreous Detachment: This is the most common cause of black visual floaters, especially in older adults. The vitreous gel in the eye shrinks and pulls away from the retina, causing floaters.
- Other Likely Diagnoses
- Posterior Vitreous Detachment (PVD): Similar to vitreous detachment, PVD occurs when the vitreous gel separates from the retina, causing floaters.
- Vitreous Degeneration: Age-related changes in the vitreous gel can cause floaters.
- Retinal Tear without Significant Hemboarthritis: A small tear in the retina can cause floaters, even if there is no significant bleeding.
- Do Not Miss Diagnoses
- Retinal Detachment: A detached retina can cause floaters, and if left untreated, can lead to permanent vision loss. It is essential to rule out this condition, even if it is less likely.
- Posterior Scleritis: Inflammation of the sclera can cause floaters, and if left untreated, can lead to serious complications.
- Ocular Malignancy (e.g., Choroidal Melanoma): Although rare, ocular malignancies can cause floaters, and early detection is crucial for treatment.
- Rare Diagnoses
- Uveitis: Inflammation of the uvea can cause floaters, but it is less common and often associated with other symptoms like eye pain and redness.
- Intraocular Infection (e.g., Endophthalmitis): A rare but serious infection within the eye can cause floaters, especially if there is a history of recent eye surgery or trauma.
- Migraine with Aura: Some people may experience floaters as part of a migraine aura, although this is relatively rare.