Cause | Common Features* | Diagnostic Approach |
---|---|---|
Clouding of normally transparent eye structures | ||
Symptoms that begin gradually Loss of the ability to distinguish between light and dark (loss of contrast) and glare (seeing halos and star bursts around lights) Often in people with risk factors (such as older age or use of corticosteroids) | A doctor's examination | |
Corneal scarring after an injury or an infection | Usually in people with a previous injury or infection | A doctor's examination |
Disorders that affect the retina | ||
Usually symptoms that begin gradually, but onset may be sudden Loss of central vision (what a person is looking at directly) much more than peripheral vision (what is seen out of the corner of the eye) | A doctor's examination Sometimes, an eye imaging test, such as optical coherence tomography (specialized imaging of the back of the eye) or fluorescein angiography (using a fluorescent dye to take images of the back of the eye) | |
Infection of the retina (as may be caused by cytomegalovirus Cytomegalovirus (CMV) Infection Cytomegalovirus infection is a common herpesvirus infection with a wide range of symptoms: from no symptoms to fever and fatigue (resembling infectious mononucleosis) to severe symptoms involving... read more or toxoplasmosis Toxoplasmosis Toxoplasmosis is infection caused by the protozoan parasite Toxoplasma gondii. Infection occurs when people unknowingly ingest toxoplasma cysts from cat feces or eat contaminated meat... read more ) | Usually in people who have HIV infection or another disorder that weakens the immune system Often eye redness or pain | Tests to check for organisms suspected to be causing the infection |
Symptoms that begin gradually Primarily night blindness | Specialized testing (such as measuring the retina's responses to light in various conditions), done by an ophthalmologist | |
Retinopathy (damage of the retina) associated with a bodywide disorder such as high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more (see hypertensive retinopathy Hypertensive Retinopathy Hypertensive retinopathy is damage to the retina (the transparent, light-sensitive structure at the back of the eye) caused by high blood pressure. When blood pressure is high (a condition called... read more ), systemic lupus erythematosus ( lupus Systemic Lupus Erythematosus (SLE) Systemic lupus erythematosus is a chronic autoimmune inflammatory connective tissue disorder that can involve joints, kidneys, skin, mucous membranes, and blood vessel walls. Problems in the... read more ), diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Symptoms of diabetes may... read more (see diabetic retinopathy Diabetic Retinopathy Diabetic retinopathy is damage to the retina (the transparent, light-sensitive structure at the back of the eye) as a result of diabetes. Blood vessels in the retina can leak blood and fluid... read more ), Waldenström macroglobulinemia Macroglobulinemia Macroglobulinemia is a plasma cell cancer in which a single clone of plasma cells produces excessive amounts of a certain type of large antibody (IgM) called macroglobulins. Although many people... read more , and multiple myeloma Multiple Myeloma Multiple myeloma is a cancer of plasma cells in which abnormal plasma cells multiply uncontrollably in the bone marrow and occasionally in other parts of the body. People often have bone pain... read more or other disorders that can cause thickening of the blood (hyperviscosity syndrome) | Often in people known to have such disorders Usually other symptoms in addition to loss of vision | A doctor's examination Tests to check for disorders suspected to be causing retinopathy |
Risk factors (for example, diabetic retinopathy, uveitis, retinal detachment or ocular injury) Blurry or distorted vision (eg, straight lines appear wavy) | A doctor's examination | |
Macular hole | Blurry vision initially in straight-ahead vision | Optical coherence tomography |
Risk factors (for example, hypertension, age, glaucoma) Painless vision loss (usually sudden) Sometimes, blurry vision | A doctor's examination Sometimes, fluorescein angiography Sometimes, optical coherence tomography (specialized imaging of the back of the eye) | |
Disorders that affect the optic nerve or its connections in the brain | ||
Missing stairs and not seeing parts of written or typed words | Measurement of pressure inside the eye (tonometry), examination of the angles between eye structures such as the cornea and iris (gonioscopy), and optic nerve testing, done by an ophthalmologist | |
Optic neuritis Optic Neuritis Optic neuritis is inflammation of the optic nerve. Multiple sclerosis is the most common cause. Loss of vision may develop, and there may be pain with eye movement. Magnetic resonance imaging... read more (inflammation of the optic nerve), which can be related to multiple sclerosis | Usually mild pain that may worsen when one eye (often) or both eyes are moved Partial or complete loss of vision Symptoms that can become severe in hours or days No effect on the eyelids and cornea | Often, MRI with contrast of the brain and orbits |
Disorders that affect focus | ||
Refractive errors Refractive Disorders (such as nearsightedness, farsightedness, and astigmatism) | Sharpness of vision (visual acuity) that varies with distance from objects Decreased acuity that can be corrected by using glasses or a pinhole device | Testing of refraction by an optometrist or ophthalmologist |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. HIV = human immunodeficiency virus; MRI = magnetic resonance imaging. |