American family physician
-
Vision loss affects more than 7 million Americans and impacts quality of life, independence, social functioning, and overall health. Common and dangerous conditions causing sudden vision loss include acute angle-closure glaucoma, retinal detachment, retinal artery occlusion, giant cell arteritis, and optic neuritis. Acute angle-closure glaucoma features ocular pain, headache, and nausea; treatment includes pilocarpine eye drops, oral or intravenous acetazolamide, and intravenous mannitol. ⋯ This condition requires immediate initiation of empiric steroids to prevent vision loss in the unaffected eye, as well as referral for a temporal artery biopsy. Optic neuritis is a demyelinating condition that features color desaturation, relative afferent pupillary defect, and pain with extraocular muscle movements. Treatment requires high-dose steroids, and patients should be evaluated for multiple sclerosis.