Ophthalmology: Loss of vision
In the second part of our series, Sophia Pathai and Andrew McNaught explain how to approach a patient who has a loss of vision
Being called to see a patient who suddenly complains of loss of vision in one or both eyes can be daunting. Understandably, the patient is often anxious, and you may be as well. The best way to tackle the problem is the same as you would for any other medical problem--start with the history and examination.
Find out about the timing of the visual loss--often it happens first thing in the morning--and the onset of symptoms. Did the visual loss last minutes or hours; did the patient wake up with the problem? Beware of “acute” visual loss that is actually of chronic duration but suddenly noticed by the patient; he or she may not be aware of visual loss in one eye until the other eye is occluded--for example, when rubbing an eyelid. Try to establish how severe the visual loss is, it can be just blurring or no perception