Sara Zarei1, Phuong Vo1, Christian Sam1, Robert W Crow1, Charles Stout1, Lama Al-Khoury1. 1. Department of Neurology (SZ, LAK), HCA Healthcare, Nashville, TN; Riverside Community Hospital (SZ, CS), CA; School of Medicine (PV, CS), UCR, Riverside, CA; Department of Ophthalmology (RWC), UCI, Irvine, CA; and Department of Interventional Neurology (CS), HCA Healthcare, Nashville, TN.
Abstract
PURPOSE OF REVIEW: Acute bilateral blindness has an extensive differential diagnosis that requires a careful history and physical examination to narrow down. In this article, we discuss the pathophysiology and radiographic findings of each possible diagnosis for acute bilateral blindness. RECENT FINDINGS: Visual pathology with respect to bilateral blindness can be broadly broken down into 3 anatomic categories: media (i.e., the anterior and posterior chamber of the eye), retina, and neural visual pathway. Possible causes of rapid onset bilateral blindness include bilateral occipital infarcts, endogenous bacterial endophthalmitis, orbital cellulitis, orbital compartment syndrome, cavernous sinus thrombophlebitis, thyroid disease, and bilateral nonarteritic ischemic optic neuropathy. SUMMARY: In this case, we present a patient with acute onset of bilateral blindness, in addition to bilateral ophthalmoplegia, proptosis, and orbital chemosis. We believe that this rare case of acute bilateral blindness is thought provoking and aids in the understanding of the differential diagnosis and underlying pathophysiology of visual loss.
PURPOSE OF REVIEW: Acute bilateral blindness has an extensive differential diagnosis that requires a careful history and physical examination to narrow down. In this article, we discuss the pathophysiology and radiographic findings of each possible diagnosis for acute bilateral blindness. RECENT FINDINGS: Visual pathology with respect to bilateral blindness can be broadly broken down into 3 anatomic categories: media (i.e., the anterior and posterior chamber of the eye), retina, and neural visual pathway. Possible causes of rapid onset bilateral blindness include bilateral occipital infarcts, endogenous bacterial endophthalmitis, orbital cellulitis, orbital compartment syndrome, cavernous sinus thrombophlebitis, thyroid disease, and bilateral nonarteritic ischemic optic neuropathy. SUMMARY: In this case, we present a patient with acute onset of bilateral blindness, in addition to bilateral ophthalmoplegia, proptosis, and orbital chemosis. We believe that this rare case of acute bilateral blindness is thought provoking and aids in the understanding of the differential diagnosis and underlying pathophysiology of visual loss.
Authors: J T Parsons; F J Bova; C R Fitzgerald; W M Mendenhall; R R Million Journal: Int J Radiat Oncol Biol Phys Date: 1994-11-15 Impact factor: 7.038