Differential Diagnosis for Sudden Onset Right Blurry Vision
Single Most Likely Diagnosis
- Retinal Detachment: Sudden onset of blurry vision, especially if accompanied by floaters or flashes of light, is highly suggestive of a retinal detachment. The asymmetry in visual acuity between the two eyes (20/50 right and 20/40 left) could indicate that the right eye is more affected.
Other Likely Diagnoses
- Central Retinal Artery Occlusion (CRAO): This condition presents with sudden, painless loss of vision in one eye and could explain the decreased visual acuity in the right eye.
- Optic Neuritis: Inflammation of the optic nerve can cause sudden vision loss, which might be more pronounced in one eye, leading to differences in visual acuity between the eyes.
- Macular Hole or Epiretinal Membrane: These conditions can cause sudden onset of blurry vision, especially if they affect the macula, the part of the retina responsible for central vision.
Do Not Miss Diagnoses
- Giant Cell Arteritis: Although less common, this condition can lead to sudden vision loss, especially in older adults, and is a medical emergency due to the risk of bilateral blindness if not promptly treated.
- Posterior Ischemic Optic Neuropathy: Similar to CRAO, this condition involves ischemia to the optic nerve but at a different location and can result in sudden vision loss.
- Acute Angle-Closure Glaucoma: This is an ocular emergency that can cause sudden vision loss, eye pain, and other symptoms. It's crucial to diagnose and treat promptly to prevent permanent vision loss.
Rare Diagnoses
- Ocular Migraine: Some types of migraines can cause transient visual disturbances, including blurry vision, but these are typically bilateral and accompanied by headache.
- Toxic or Medication-Induced Optic Neuropathy: Certain substances can cause optic neuropathy leading to vision loss, which might present unilaterally or bilaterally.
- Inherited Retinal Diseases: Conditions like Leber's hereditary optic neuropathy can cause sudden vision loss, particularly in young adults, but these are less common and often have a familial component.
Each of these diagnoses has a different set of risk factors, symptoms, and diagnostic approaches. A comprehensive eye examination, including visual acuity testing, fundoscopy, and possibly imaging studies like OCT (Optical Coherence Tomography), is essential for determining the underlying cause of sudden onset blurry vision.