Semin Neurol 2010; 30(1): 044-050
DOI: 10.1055/s-0029-1244997
© Thieme Medical Publishers

Pearls: Visual Loss

Wayne T. Cornblath1
  • 1Departments of Ophthalmology and Visual Sciences and Neurology, University of Michigan, Ann Arbor, Michigan
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
01. Februar 2010 (online)

ABSTRACT

The clinician who is evaluating a patient with visual loss faces a large initial differential diagnosis. By taking a systematic approach to the history of the present illness, including reviewing systems, examination, and subsequent testing, several potential pitfalls will be avoided, and a brief differential diagnosis list can be generated. This article uses illustrative cases to present a variety of history, examination, and testing pearls for diagnosing the source of visual loss.

REFERENCES

  • 1 Paul H. Phillips’ toxic and deficiency optic neuropathies. In: Miller NR, Newman NJ, Biousse V, Kerrison JB Walsh and Hoyt’s Clinical Neuro-ophthalmology. 6th ed. Philadelphia, PA; Lippincott Williams & Wilkins 2005: 447-463
  • 2 Wolin M J. Digoxin visual toxicity with therapeutic blood levels of digoxin.  Am J Ophthalmol. 1998;  125(3) 406-407
  • 3 Hayreh S S. Role of nocturnal arterial hypotension in the development of ocular manifestations of systemic arterial hypertension.  Curr Opin Ophthalmol. 1999;  10(6) 474-482
  • 4 Chiu A M, Chuenkongkaew W L, Cornblath W T et al.. Minocycline treatment and pseudotumor cerebri syndrome.  Am J Ophthalmol. 1998;  126(1) 116-121
  • 5 Friedman D I, Gordon L K, Egan R A et al.. Doxycycline and intracranial hypertension.  Neurology. 2004;  62(12) 2297-2299
  • 6 David N J. Pituitary apoplexy goes to the bar: litigation for delayed diagnosis, deficient vision, and death.  J Neuroophthalmol. 2006;  26(2) 128-133
  • 7 Melberg N S, Grand M G, Dieckert J P et al.. Cotton-wool spots and the early diagnosis of giant cell arteritis.  Ophthalmology. 1995;  102(11) 1611-1614
  • 8 Parikh M, Miller N R, Lee A G et al.. Prevalence of a normal C-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis.  Ophthalmology. 2006;  113(10) 1842-1845
  • 9 Hall S, Persellin S, Lie J T, O’Brien P C, Kurland L T, Hunder G G. The therapeutic impact of temporal artery biopsy.  Lancet. 1983;  2(8361) 1217-1220
  • 10 Weyand C M, Goronzy J J. Giant-cell arteritis and polymyalgia rheumatica.  Ann Intern Med. 2003;  139(6) 505-515
  • 11 Wolintz R J, Trobe J D, Cornblath W T, Gebarski S S, Mark A S, Kolsky M P. Common errors in the use of magnetic resonance imaging for neuro-ophthalmic diagnosis.  Surv Ophthalmol. 2000;  45(2) 107-114

Wayne T CornblathM.D. 

Professor, Departments of Ophthalmology and Visual Sciences and Neurology, University of Michigan

1000 Wall Street, Ann Arbor, MI 48105; reprints are not available from the author

eMail: wtc@med.umich.edu

    >