Differential Diagnosis for Unable to See out of Left Peripheral Field
- Single most likely diagnosis
- Homonymous Hemianopia: This condition, where there is a loss of vision in the same half of the visual field of both eyes, is often due to a lesion in the brain, such as a stroke affecting the optic tract, radiation, or the visual cortex. The left peripheral field defect suggests a right-sided brain lesion.
- Other Likely diagnoses
- Glaucoma: Especially if the patient has a history of glaucoma, as it can cause peripheral vision loss, typically starting with the nasal field but can progress.
- Retinal Detachment: Can cause a shadow or curtain descending over the field of vision, which might initially be perceived as a loss of peripheral vision.
- Optic Neuritis: Inflammation of the optic nerve can cause a variety of visual disturbances, including loss of peripheral vision, though it more commonly affects central vision.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pituitary Tumor: Although less common, a pituitary tumor can cause bitemporal hemianopia due to its location near the optic chiasm. However, if it expands laterally, it could potentially affect one side more than the other, leading to a unilateral peripheral field defect.
- Brain Tumors: Other than pituitary tumors, any tumor affecting the optic pathway (e.g., meningioma, glioma) could potentially cause a visual field defect.
- Stroke or Transient Ischemic Attack (TIA): Acute onset of visual field loss could be a symptom of a stroke or TIA, which requires immediate medical attention.
- Rare diagnoses
- Chiasmal Syndromes: Conditions affecting the optic chiasm, such as those caused by suprasellar tumors or cysts, can lead to a variety of visual field defects, including hemianopic defects.
- Traumatic Optic Neuropathy: Direct trauma to the optic nerve can cause visual field defects, including peripheral field loss.
- Inherited Conditions: Certain inherited conditions, like Leber's hereditary optic neuropathy, can cause progressive visual field loss, though these typically affect central vision first.