Acute monocular vision loss: Diagnostic clues from the history
| Feature | Common conditions | Additional features |
|---|---|---|
| Eye pain | Acute angle-closure glaucoma | Age > 60 and family history Deep brow, headache with nausea and vomiting Halos around lights |
| Optic neuritis | Pain worsens with eye movements Loss of color vision (red desaturation) | |
| Keratitis (inflammation of the cornea) | Sharp superficial pain (“grittiness”) Discharge from the eye | |
| Conjunctival hyperemia (red eye) | Acute angle-closure glaucoma | See above |
| Keratitis | See above | |
| Uveitis | Redness prominent at limbus (convergence between cornea and sclera) Photophobia Systemic features suggesting autoimmune disease | |
| Headache | Giant cell arteritis | Age > 50 Scalp tenderness (new onset, temporally based headache) Jaw claudication Proximal muscle pain |
| Migraine | Younger patients Preceded by migraine prodrome Symptoms resolve within hour | |
| Photopsia (flashes of bright light) | Retinal detachment | Myopia Recent history of ophthalmic procedures Partial loss of peripheral field |
| Preceding trauma | Keratitis or uveitis | Accompanying milder trauma |
| Hyphema (blood in the anterior chamber) | History of blunt trauma Recent history of ophthalmic procedures | |
| Lens dislocation or rupture | Predisposed by congenital conditions Associated small, irregular pupil |
Information from references 2 and 3.