blurry vision: differential diagnoses and treatment:
🔹 1. Differential Diagnoses
A. Refractive / Ocular Surface Causes
• Refractive errors (myopia, hyperopia, astigmatism, presbyopia).
• Dry eye syndrome → fluctuating vision, burning, irritation.
• Corneal abrasion / keratitis → pain, photophobia, foreign body
sensation.
• Cataracts → gradual, painless vision loss; glare/halos at night.
B. Retinal Causes
• Diabetic retinopathy → blurred vision, floaters, dark spots.
• Macular degeneration (AMD) → central vision distortion, scotomas.
• Retinal detachment → sudden flashes, floaters, “curtain” over vision
(emergency).
C. Optic Nerve / Neurologic Causes
• Optic neuritis → unilateral blurry vision, pain with eye
movement (often young adults, MS).
• Stroke/TIA → sudden visual field defects, monocular or binocular.
• Intracranial mass / increased ICP → papilledema, transient visual
obscurations.
D. Vascular / Acute Causes
• Retinal vein occlusion → sudden painless vision loss, “blood and
thunder” fundus.
• Retinal artery occlusion → sudden profound vision loss, cherry-
red spot (ocular emergency).
• Hypertensive retinopathy → chronic blurring, vessel changes.
E. Other
• Medication-related: Anticholinergics, topiramate, corticosteroids
(cataracts, glaucoma).
🔹 1. Differential Diagnoses
A. Refractive / Ocular Surface Causes
• Refractive errors (myopia, hyperopia, astigmatism, presbyopia).
• Dry eye syndrome → fluctuating vision, burning, irritation.
• Corneal abrasion / keratitis → pain, photophobia, foreign body
sensation.
• Cataracts → gradual, painless vision loss; glare/halos at night.
B. Retinal Causes
• Diabetic retinopathy → blurred vision, floaters, dark spots.
• Macular degeneration (AMD) → central vision distortion, scotomas.
• Retinal detachment → sudden flashes, floaters, “curtain” over vision
(emergency).
C. Optic Nerve / Neurologic Causes
• Optic neuritis → unilateral blurry vision, pain with eye
movement (often young adults, MS).
• Stroke/TIA → sudden visual field defects, monocular or binocular.
• Intracranial mass / increased ICP → papilledema, transient visual
obscurations.
D. Vascular / Acute Causes
• Retinal vein occlusion → sudden painless vision loss, “blood and
thunder” fundus.
• Retinal artery occlusion → sudden profound vision loss, cherry-
red spot (ocular emergency).
• Hypertensive retinopathy → chronic blurring, vessel changes.
E. Other
• Medication-related: Anticholinergics, topiramate, corticosteroids
(cataracts, glaucoma).
