JAMA PATIENT PAGE | Ophthalmology

Sudden Vision Loss

Vision loss is caused by problems at any point along the visual pathway
from the eyes to the brain, and sudden vision loss is an emergency.
The process of vision involves light passing into the eye and being
transformed into electrical signals that are processed in the brain. The Visual Pathway
Light enters the eye through an opening called the pupil and is Light enters the eye through the pupil
and is changed into electrical signals
changed into electrical signals by cells located toward the back of
by cells located in the back of the eye
the eye in the retina. These signals then travel from the eyes through in the retina. BRAIN
the optic nerves to the brain. In the brain, the occipital lobes pro-
cess the visual information to make sense of it. Problems at any point Top view of the brain
along this visual pathway can cause vision loss. Light
Eye Pupil

Signs and Symptoms Retina

Sudden vision loss is vision loss that occurs over a period of a few
seconds or minutes to a few days. Vision may become blurry or Path of visual Path of visual
information information
cloudy, completely absent, or affected by flashing lights or specks from right from left
visual field visual field
in the visual field called floaters. Part of the field of vision or the en-
tire field of vision may be affected. It is helpful to cover one eye and These electrical signals travel
to the occipital lobes of the
then the other to determine whether one eye or both eyes are af- brain where visual information
fected. Sudden vision loss is most often painless but may be asso- is processed.
ciated with eye pain, redness, and headache. Any sudden change Occipital Disruptions anywhere along
lobes this path can cause vision loss.
in vision is potentially serious, even if it involves only part of the vi-
sual field or resolves on its own.
Treatment
Causes
Vision loss due to problems with the eye may be treated with eye
Common causes of sudden vision loss include eye trauma, block-
drops, medications, or surgery. If inflammation is the cause of the
age of blood flow to or from the retina (retinal artery occlusion or
vision loss, steroids may be used. If the vision loss is caused by a sud-
retinal vein occlusion), and pulling of the retina away from its
den blockage of a blood vessel, treatment is directed at improving
usual position at the back of the eye (retinal detachment). Inflam-
blood flow as soon as possible. Depending on the cause, vision loss
mation of the blood vessels that supply the eye and the optic nerve
can be minimized or reversed if treatment occurs quickly.
or inflammation of the optic nerve itself can also cause vision loss.
A sudden blockage of blood flow to the occipital lobe of the brain
(as can occur with a stroke) is another common cause of sudden FOR MORE INFORMATION
vision loss. • American Academy of Ophthalmology
https://www.aao.org/eye-health/diseases/detached-torn-retina
Evaluation -vision-simulator
Sudden vision loss is a medical emergency, and anyone with sud- • Merck Manual
den vision loss should seek medical attention quickly. Evaluation http://www.merckmanuals.com/home/eye-disorders/symptoms
may include an eye examination and a neurological examination to -of-eye-disorders/vision-loss,-sudden
test the function of the eyes and brain. Blood tests and brain • National Library of Medicine
imaging tests may also be ordered as part of the initial evaluation. https://medlineplus.gov/ency/article/003040.htm
The examination and tests are performed to look for specific eye
problems as well as generalized medical conditions that may be To find this and other JAMA Patient Pages, go to the For Patients
collection at jamanetworkpatientpages.com.
related to the vision loss.

Author: Christopher C. Muth, MD
Sources: Merck Manual, National Library of Medicine, American Academy of
Ophthalmology
Newman N, Biousse V. Diagnostic approach to vision loss. Continuum (Minneap Minn).
2014;20(4):785-815.
Bagheri N, Mehta S. Acute vision loss. Prim Care Clin Office Pract. 2015;42(3):347-361.
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