What are the neurologic causes of sudden visual loss?

Updated: Dec 11, 2019
  • Author: Jean Deschênes, MD, FRCSC; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

Optic neuritis is usually seen in patients younger than 45 years and often presents with pain upon eye movement. Patients describe seeing things as dark or unclear, and colors may appear pale. Vision loss may be worse with heat or exertion, known as the Uhthoff phenomenon. Vision deteriorates over a few days and subsequently nadirs within 1-2 weeks and then ultimately improves. [30]

Pituitary apoplexy can cause sudden peripheral field loss, usually associated with ocular motility deficit.

Sphenoid sinusitis may cause vision loss. Phycomycosis occasionally manifests as a nasal or palatal eschar in immunocompromised patients.

Occipital stroke may cause homonymous visual field loss with no appendicular or speech deficits. Visual acuity may be normal if there is macular sparing. Patients may report homonymous paracentral scotoma.


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