| Laterality | Pain | Redness | Other eye symptoms or findings | Other symptoms or things to be noticed |
---|
- In hours, days, weeks, months, years
- Both eyes may be affected at different times and recurrently; ALWAYS suspect systemic disease if symptoms are bilateral.
|
Sudden, in minutes-hours |
Acute angle-closure glaucoma | Unilateral | Yes | Yes | Blurred vision, reduced visual acuity, intraocular pressure may be > 30 mmHg | Headache, abdominal pain, nausea |
Giant cell arteritis (previously temporal arteritis) | Uni-or bilateral | No | No | Visual acuity ↓-↓↓↓ | Headache, impaired general condition, weight loss |
Central artery occlusion | Unilateral | No | No | Visual acuity ↓↓↓; cherry-red spot in the macula, pale retina | No general symptoms |
Intoxication (methanol, quinine) | Bilateral | No | No | Visual acuity ↓↓↓, tunnel vision | General symptoms |
Non-arteritic anterior ischaemic optic neuropathy (NAION) | Unilateral (bilateral) | No | No | Visual acuity ↓-↓↓↓, sectoral visual field defect | No other eye symptoms (cardiovascular diseases as predisposing factors) |
Central vein occlusion or branch vein occlusion affecting the macula | Unilateral | No | No | Visual acuity ↓-↓↓, flame- or patch-shaped retinal haemorrhages and oedema, often also microinfarctions | No other eye symptoms (predisposing factors hypertension, hypercholesterolaemia, diabetes / metabolic syndrome, coagulation disorders, malignant diseases) |
Vitreous haemorrhage | Unilateral | No | No | Visual acuity ↓-↓↓↓; flashing and veil-like visual disturbance: vitreous detachment | No other eye symptoms (predisposing factors diabetes, cardiovascular diseases, anticoagulant treatment, trauma) |
Haemorrhage in the fovea | Unilateral | No | No | Visual acuity ↓↓↓↓; myopia | No other eye or systemic symptoms |
Retinal detachment | Unilateral | No | No | Visual acuity ↓-↓↓↓; often preceding symptoms of vitreous detachment; myopia | No other eye symptoms (predisposing factors injury, intraocular operations) |
Epidemic nephropathy | Bilateral | No | No/Yes | Visual acuity ↓-↓↓; transient myopia, possibly increase in intraocular pressure (usually decreases) | General symptoms of epidemic nephropathy |
Hypo- or hyperglycaemia | Bilateral | No | No | Visual acuity ↓-↓↓; in case of hyperglycaemia, possibly transient myopia (impaired distance vision) | Undiagnosed diabetes |
Periodic (with typical duration) |
Papilloedema (seconds, attacks of blurred vision less than one second long) | Bilateral | No | No | Visual acuity ↓-↓↓↓; may be transient, of a few seconds' duration | Headache and nausea in the morning as general symptoms of increased intracranial pressure |
Amaurosis fugax (minutes) | Uni- (or bilateral) | No | No | There may be transient total vision loss (of usually several minutes) | No general symptoms |
Migraine (ca. 15-20 min., up to 1-2 hours) | (Uni- or) bilateral | No | No | Visual acuity ↓-↓↓; serrated figures, transient visual field defect; transient diplopia possible | (Unilateral) headache, nausea |
Dry eyes | (Uni- or) bilateral | Mild | No/Yes | Visual acuity ↓↓ | Elderly persons; predisposing factors (medication, such as isotretinoin) and locations, significantly prolonged visual display terminal use |
Rapid or gradual (speed of development) 1) |
Keratitis (days) | Unilateral (bilateral) | Yes | Yes | Visual acuity ↓-↓↓ | No other eye symptoms (predisposing factors prior injury or wearing of contact lenses) |
Recurrent corneal erosion | Unilateral | Yes | Yes/No | Visual acuity ↓-↓↓ | Severe pain often with onset at night; often with prior injury; may also occur in the morning when opening the eyes |
Corneal oedema (hours-days) | Uni- or bilateral | No/Yes | No/Yes | Visual acuity ↓-↓↓ | If corneal oedema is due to acute angle-closure glaucoma, intraocular pressure is elevated (often more than 50-80 mmHg). |
Endophthalmitis (hours-days) | Unilateral | Yes | Yes | Visual acuity ↓-↓↓↓ | No other eye symptoms (predisposing factors prior ophthalmic operation, intravitreal injection, injury or immunosuppression) |
Iridocyclitis (days) | Unilateral (bilateral)2) | Yes | Yes | Visual acuity ↓-↓↓↓, photophobia, pain, small pupil, redness around the cornea | General symptoms associated with systemic diseases possible (predisposing factors rheumatic diseases, various systemic diseases) |
Macular oedema (hours-days) | Uni- or bilateral | No | No | Visual acuity ↓-↓↓↓ | Other eye symptoms also possible (macular oedema may occur after diabetic retinopathy, central or branch venous thrombosis, uveitis, cataract surgery, for example) |
Age-related macular degeneration (days, weeks) | Uni- or bilateral | No | No | Visual acuity ↓-↓↓↓, central dim area; line distortion | No other eye or systemic symptoms |
Macular hole and preretinal fibrosis (puckering of the macula) | Unilateral | No | No | Visual acuity ↓-↓↓, line distortion, missing letters | No other eye or systemic symptoms (macular hole and preretinal fibrosis are often associated with incomplete posterior vitreous detachment) |
Cataract (hours-days) | (Uni- or) bilateral | No | No | Visual acuity ↓-↓↓↓, glare, blurred vision, often increased myopia, monocular diplopia | No other eye symptoms (rapidly developing form associated with strongly varying blood sugar levels) |
Openn-angle glaucoma (years) | Uni- or bilateral | No | No | Visual acuity ↓-↓↓, visual field defects | No other eye or systemic symptoms |
Optic neuritis (a day-days) | Unilateral (bilateral)2) | Yes | No | Visual acuity ↓-↓↓, the papilla may be indistinctly defined | Possibly symptoms of MS; eye pain and tendernesson eye movement |
Compressive lesion of the optic nerve/ optic pathway (months-years) | Uni- or bilateral | No | No | Visual acuity ↓-↓↓, papillary stasis possible | General symptoms possible: symptoms of a brain tumour or an aneurysm |
Chorioretinitis (days-weeks) | Unilateral2) | No/Yes | No | Visual acuity ↓-↓↓↓, retinal inflammatory changes | General symptoms possible |
Hereditary retinal degeneration, e.g. retinitis pigmentosa http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Expert=791 | Bilateral | No | No | Visual acuity ↓-↓↓, often deterioration of night vision, narrowing of the visual field | General symptoms possible (syndromes, such as Usher's syndrome also associated with loss of hearing) |
Adverse effect of a drug (such as ethambutol, thioridazine, chloroquine, amiodarone, tamoxifen, gentamicin) | Bilateral | No | No | Visual acuity ↓-↓↓ | Other possible adverse effects |