Explanation - Acute loss or rapid loss of vision can be due to many causes. In general, "loss" varies from patient to patient, that is, some patients feel that they have "lost" all vision, but can still read road signs and TV. Others, however, might not be able to see the "broad side of a barn" and are limited to seeing light or large moving objects only. It is very unlikely that a patient loses all vision (even light perception) quickly.

Diagnoses - Possibilities include; a cerebral vascular accident (CVA) or "stroke," loss of blood supply or inflammation of the optic nerve, loss of blood supply to the retina (see BRVO, CRVO, Arterial Occlusions), vitreous hemorrhage or retinal detachment.

Stroke - in this scenario, a patient loses blood supply to the a portion of the brain involving the so-called visual pathway. There are portions of the brain that affect vision. Damage to these areas could severly impact vision.

Optic Nerve Damage - there are two possibilities leading to acute vision loss. The first, anterior ischemic optic neuropathy (AION) is basically sudden loss of blood supply to the optic nerve leading to sudden loss of vision. A visual field should be obtained along with consultation with a neuro-ophthalmologist or retinal specialist. The second possibility is cases of optic neuritis, or inflammation of the optic nerve. While the onset may not be as sudden, significant visual loss can result from the optic nerve swelling. Consultation with a neuro-ophthalmologist may be appropriate.

Vascular Occlusions - loss of blood flow from either the venous or arterial side can lead to abrupt loss of vision. Diagnosis is usually made by examination. Treatment is limited. Take a look at the different types of vascular occlusions; Central Retinal Vein Occlusion (CRVO), Branch Retinal Vein Occlusions (BRVO) and Arterial Occlusions (CRAO and BRAO).

Vitreous Hemorrhage may cause acute loss of vision by filling the vitreous cavity and thereby blocking light from hitting the retina. Causes are usually a retinal tear (the tear rips across a retinal blood vessel) or proliferative diabetic retinopathy. There are a few more uncommon causes.

Retinal detachment is usually a rapid loss of vision and after careful interrogation, one finds that it is a progressively rapid loss of vision starting with loss of peripheral vision. Visual loss, when involving the macula, is usually pronounced. Surgical intervention is required.

Source: www.randallwongmd.com

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