Persistent Visual Loss
- Visual loss affecting one or both eyes that endures
- Causative abnormality may lie in ocular media (cornea, lens, vitreous), retina, or visual pathway behind eyes
- Visual loss may also be consciously or unconsciously faked (Psychogenic Visual Loss)
- Patient may describe blurred, blank, sparkling, dim, or dark areas in front of eye(s)
- May be isolated symptom
- Exam usually shows reduced visual acuity and/or visual field
- Ocular media abnormalities often visible on slit lamp or ophthalmoscopic examination
- Visual pathway lesions often localizable by pattern of visual field defects
- Patients whose eyes become misaligned (strabismus) may report blurred vision when they are really experiencing double vision (diplopia)
- If covering either eye eliminates blur, actual symptom is double vision
- If visual loss is acute, refer emergently
- If visual loss is chronic, refer non-emergently
- Many conditions causing acute visual loss require prompt treatment to prevent catastrophic outcomes
- Some chronic conditions (refractive error, cataract, keratopathy, certain optic neuropathies) can be effectively treated