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BLINDNESS

BLINDNESS: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the following questions:

  1. Is it transient? Transient blindness may occur in transient ischemic attacks, epilepsy, migraine, and hypertension.
  2. Is it a sudden onset? The sudden onset of blindness may occur in optic neuritis, retinal vein thrombosis, central retinal artery occlusion, vitreous hemorrhage, detached retina, carotid artery thrombosis, temporal arteritis, injuries to the optic nerve, retrobulbar neuritis, fracture of the skull, glaucoma, posterior cerebral artery occlusion, multiple sclerosis, and hysteria.
  3. Is it unilateral or bilateral? Unilateral blindness may occur in glaucoma, vitreous hemorrhage, optic neuritis, retinal vein thrombosis, central retinal artery thrombosis, carotid artery thrombosis, temporal arteritis, injury to the optic nerve, fractured skull, brain tumors, retinoblastomas, and sphenoid ridge meningiomas. Bilateral blindness may occur in posterior cerebral artery occlusion, pituitary tumors, retinitis pigmentosa, hereditary optic atrophy, uveitis, toxic amblyopia, cataracts, glaucoma, multiple sclerosis, and iritis.
  4. Is there papilledema? The presence of papilledema should make one suspect optic neuritis, retinal vein thrombosis, and space-occupying lesions of the brain.
  5. Are there abnormalities on ophthalmoscopic examination? Besides papilledema, there may be changes on the ophthalmoscopic examination in iritis, glaucoma, papillitis from optic neuritis, retinal vein thrombosis, central retinal artery occlusion, vitreous hemorrhage, detached retina, and retinoblastoma.

DIAGNOSTIC WORKUP

Referral to an ophthalmologist is usually the first step in a good workup. If one is not available, a careful eye examination including slit lamp examination, visual acuity evaluation, tonometry, and visual field studies should be done. If these are unrevealing, a referral to an ophthalmologist or neurologist should be made without further delay. Additional studies would include a CT scan or MRI of the brain and orbits, carotid scans, spinal tap, VEP studies, and four-vessel cerebral angiography. An EEG would be useful in diagnosing hysterical blindness and malingering.

Book Source Details

  • Book Title: Algorithmic Diagnosis of Symptoms and Signs
  • Author(s): R. Douglas Collins
  • Year of Publication: 2003
  • Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

More About Color blindness

More Medical Textbooks Online about Color blindness

Review other book chapters online related to Color blindness:

Medical Books Excerpts
  • EYE PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • SCOTOMA
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • BLINDNESS
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • EYE PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • Eye pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • Scotoma
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • Scotoma
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • Scotoma
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • Eye Pain
  • "Field Guide to Bedside Diagnosis" (2007)
  • Eye pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • Eye pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • Scotoma
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • Scotoma
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • EYE PAIN
  • "Differential Diagnosis in Primary Care" (2007)
 

Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.




More About This Book:
Title: Algorithmic Diagnosis of Symptoms and Signs
Authors: R. Douglas Collins
Publisher: Lippincott Williams & Wilkins
Copyright: 2003
ISBN: 0-7817-3805-9

 » Next page: EYE PAIN (Differential Diagnosis in Primary Care)

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