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Author: Jonathan Trobe, MD, 2009

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COMMON EYE SYMPTOMS
            Jonathan D. Trobe, MD
  Departments of Ophthalmology and Neurology
     University of Michigan Medical School
Causes of Transient Visual Loss
•  Monocular
       1. If abrupt onset, usually ischemia to
   retina or optic nerve
       2. Local causes: papilledema or
   impending retinal or optic nerve vascular
   occlusion
       3. Remote causes: cervical carotid
   artery stenosis or systemic hypotension
Intraluminal Retinal Artery (Hollenhorst) Plaque




 Source Undetermined
Causes of Transient Visual Loss
•  Binocular
    1. Visual cortex ischemia

    2. Migraine
Source Undetermined
S. Jähnichen (Wikimedia Commons)
S. Jähnichen (Wikimedia Commons)
S. Jähnichen (Wikimedia Commons)
Causes of Acute
          Persistent Visual Loss
1.Vitreous hemorrhage

2. Retinal detachment

3. Retinal hemorrhage

4. Retinal infection

5. Retinal artery occlusion
Causes of Acute
         Persistent Visual Loss
6. Optic nerve infarction (ischemic optic
     neuropathy)

7. Optic neuritis

8. Optic nerve compression/infiltration by
  cancer
Causes of Acute
         Persistent Visual Loss

9. Occipital lobe infarction
Causes of Acute
        Persistent Visual Loss

10. Psychogenic illness
Vitreous Hemorrhage




Source Undetermined
Retinal Detachment




Source Undetermined
Retinal Detachment




Source Undetermined
Source Undetermined
Source Undetermined
Source Undetermined
Macular Hemorrhage




Source Undetermined
Macular Infection




Source Undetermined
Source Undetermined
Retinal Artery Occlusion




Source Undetermined
Normal Retina




Source Undetermined
Retinal Vein Occlusion




Source Undetermined
Optic Nerve Infarction




Source Undetermined
Optic Neuritis




Source Undetermined
Occipital Lobe Infarction




   Source Undetermined
Causes of Flashes of Light
•  Monocular
  1. Vitreoretinal traction
  2. Impending retinal vascular occlusion


•  Binocular
  1. Migraine
  2. Occipital lobe ischemia
Source Undetermined
Source Undetermined
S. Jähnichen (Wikimedia Commons)
Causes of Floaters
•    Aging or myopic vitreous
•    Vitreous detachment
•    Vitreous hemorrhage
•    Vitreous inflammation
Source Undetermined
Causes of Diplopia

•     Binocular

     1.  Ocular misalignment
     2.  Psychogenic

•     Monocular

      1. Uncorrected refractive error
      2. Corneal lesion
      3. Cataract
Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006.
Causes of Optic Disc Excavation
•  Physiologic
•  Glaucoma
•  Other optic neuropathies
Source Undetermined
Source Undetermined
Source Undetermined
Additional Source Information
               for more information see: http://open.umich.edu/wiki/CitationPolicy

Slide 5 – Source Undetermined
Slide 7 – Source Undetermined
Slide 8 – Beginning aura of a migraine S. Jähnichen (Wikimedia Commons)
http://commons.wikimedia.org/wiki/File:Fortifikation_(Migr%C3%A4ne).jpg replaced an image of an aura forming
around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of
Ophthalmology, 2006.
Slide 9 – Mid-stage of migraine aura S. Jähnichen (Wikimedia Commons)
http://commons.wikimedia.org/wiki/File:Negatives_Skotom_(Brandenburger_Tor_Blaue_Stunde)_1.jpg replaced
an image of an aura forming around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e.
American Academy of Ophthalmology, 2006.
Slide 10 – Full aura of migraine S. Jähnichen (Wikimedia Commons)
http://commons.wikimedia.org/wiki/File:Gesichtsfeldausfall_(Brandenburger_Tor_Blaue_Stunde)_1.jpg replaced
an image of an aura forming around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e.
American Academy of Ophthalmology, 2006.
Slide 15 – Source Undetermined
Slide 16 – Source Undetermined
Slide 17 – Source Undetermined
Slide 18 – Source Undetermined
Slide 19 – Source Undetermined
Slide 20 – Source Undetermined
Slide 21 – Source Undetermined
Slide 22 – Source Undetermined
Slide 23 – Source Undetermined
Slide 24 – Source Undetermined
Slide 25 – Source Undetermined
Slide 26 – Source Undetermined
Slide 27 – Source Undetermined
Slide 28 – Source Undetermined
Slide 29 – Source Undetermined
Additional Source Information
                 for more information see: http://open.umich.edu/wiki/CitationPolicy



Slide 31 – Source Undetermined
Slide 32 – Source Undetermined
Slide 33 – Mid-stage of migraine aura S. Jähnichen (Wikimedia Commons)
http://commons.wikimedia.org/wiki/File:Negatives_Skotom_(Brandenburger_Tor_Blaue_Stunde)_1.jpg replaced
an image of an aura forming around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e.
American Academy of Ophthalmology, 2006.
Slide 35 – Source Undetermined
Slide 37 – Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006.
Slide 39 – Source Undetermined
Slide 40 – Source Undetermined
Slide 41 – Source Undetermined

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11.21.08(b): Common Eye Symptoms

  • 1. Author: Jonathan Trobe, MD, 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution 3.0 License: http://creativecommons.org/licenses/by/3.0/ We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact open.michigan@umich.edu with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use. Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
  • 2. Citation Key for more information see: http://open.umich.edu/wiki/CitationPolicy Use + Share + Adapt { Content the copyright holder, author, or law permits you to use, share and adapt. } Public Domain – Government: Works that are produced by the U.S. Government. (USC 17 § 105) Public Domain – Expired: Works that are no longer protected due to an expired copyright term. Public Domain – Self Dedicated: Works that a copyright holder has dedicated to the public domain. Creative Commons – Zero Waiver Creative Commons – Attribution License Creative Commons – Attribution Share Alike License Creative Commons – Attribution Noncommercial License Creative Commons – Attribution Noncommercial Share Alike License GNU – Free Documentation License Make Your Own Assessment { Content Open.Michigan believes can be used, shared, and adapted because it is ineligible for copyright. } Public Domain – Ineligible: Works that are ineligible for copyright protection in the U.S. (USC 17 § 102(b)) *laws in your jurisdiction may differ { Content Open.Michigan has used under a Fair Use determination. } Fair Use: Use of works that is determined to be Fair consistent with the U.S. Copyright Act. (USC 17 § 107) *laws in your jurisdiction may differ Our determination DOES NOT mean that all uses of this 3rd-party content are Fair Uses and we DO NOT guarantee that your use of the content is Fair. To use this content you should do your own independent analysis to determine whether or not your use will be Fair.
  • 3. COMMON EYE SYMPTOMS Jonathan D. Trobe, MD Departments of Ophthalmology and Neurology University of Michigan Medical School
  • 4. Causes of Transient Visual Loss •  Monocular 1. If abrupt onset, usually ischemia to retina or optic nerve 2. Local causes: papilledema or impending retinal or optic nerve vascular occlusion 3. Remote causes: cervical carotid artery stenosis or systemic hypotension
  • 5. Intraluminal Retinal Artery (Hollenhorst) Plaque Source Undetermined
  • 6. Causes of Transient Visual Loss •  Binocular 1. Visual cortex ischemia 2. Migraine
  • 11. Causes of Acute Persistent Visual Loss 1.Vitreous hemorrhage 2. Retinal detachment 3. Retinal hemorrhage 4. Retinal infection 5. Retinal artery occlusion
  • 12. Causes of Acute Persistent Visual Loss 6. Optic nerve infarction (ischemic optic neuropathy) 7. Optic neuritis 8. Optic nerve compression/infiltration by cancer
  • 13. Causes of Acute Persistent Visual Loss 9. Occipital lobe infarction
  • 14. Causes of Acute Persistent Visual Loss 10. Psychogenic illness
  • 29. Occipital Lobe Infarction Source Undetermined
  • 30. Causes of Flashes of Light •  Monocular 1. Vitreoretinal traction 2. Impending retinal vascular occlusion •  Binocular 1. Migraine 2. Occipital lobe ischemia
  • 34. Causes of Floaters •  Aging or myopic vitreous •  Vitreous detachment •  Vitreous hemorrhage •  Vitreous inflammation
  • 36. Causes of Diplopia •  Binocular 1.  Ocular misalignment 2.  Psychogenic •  Monocular 1. Uncorrected refractive error 2. Corneal lesion 3. Cataract
  • 37. Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006.
  • 38. Causes of Optic Disc Excavation •  Physiologic •  Glaucoma •  Other optic neuropathies
  • 42. Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicy Slide 5 – Source Undetermined Slide 7 – Source Undetermined Slide 8 – Beginning aura of a migraine S. Jähnichen (Wikimedia Commons) http://commons.wikimedia.org/wiki/File:Fortifikation_(Migr%C3%A4ne).jpg replaced an image of an aura forming around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006. Slide 9 – Mid-stage of migraine aura S. Jähnichen (Wikimedia Commons) http://commons.wikimedia.org/wiki/File:Negatives_Skotom_(Brandenburger_Tor_Blaue_Stunde)_1.jpg replaced an image of an aura forming around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006. Slide 10 – Full aura of migraine S. Jähnichen (Wikimedia Commons) http://commons.wikimedia.org/wiki/File:Gesichtsfeldausfall_(Brandenburger_Tor_Blaue_Stunde)_1.jpg replaced an image of an aura forming around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006. Slide 15 – Source Undetermined Slide 16 – Source Undetermined Slide 17 – Source Undetermined Slide 18 – Source Undetermined Slide 19 – Source Undetermined Slide 20 – Source Undetermined Slide 21 – Source Undetermined Slide 22 – Source Undetermined Slide 23 – Source Undetermined Slide 24 – Source Undetermined Slide 25 – Source Undetermined Slide 26 – Source Undetermined Slide 27 – Source Undetermined Slide 28 – Source Undetermined Slide 29 – Source Undetermined
  • 43. Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicy Slide 31 – Source Undetermined Slide 32 – Source Undetermined Slide 33 – Mid-stage of migraine aura S. Jähnichen (Wikimedia Commons) http://commons.wikimedia.org/wiki/File:Negatives_Skotom_(Brandenburger_Tor_Blaue_Stunde)_1.jpg replaced an image of an aura forming around a wrist watch from Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006. Slide 35 – Source Undetermined Slide 37 – Trobe, J. The Physician s Guide to Eye Care. 3e. American Academy of Ophthalmology, 2006. Slide 39 – Source Undetermined Slide 40 – Source Undetermined Slide 41 – Source Undetermined