Boards 3 will's eye

burning sensation ddx

bleph, meibomitis, des, conjuncitivits (inflamed pterygium/pinguecula, episcleritis, SLK, ocular toxicity (meds,makeup,CTL solutions) CTL problems

decreased va monocular acute painless ddx

RAO or RVO, ophthalmic artery occlusion, ischemic optic neuropathy, GCA, vit heme, RD, sudden discovery of pre-existing unilateral va loss

decreased acute monocular painful va loss ddx

k lesion (abrasion,ulcer) uveitis, des, acute angle closure, endophthalmitis, k hydrops, optic neuritis (pain with eye movement however 10% are painless) and retinal detachment.

transient monocular va loss ddx

amaurosis fugax, optic disc drusen, impending crvo (essentially a TIA), ocular ischemic syndrome, orthostatic hypotension

transient painful monocular va loss ddx

migraine, des, SPKneuroretinitis, posterior scleritis, herpes zoster ophthalmicus.

painless acute/transient binocular va loss ddx

stroke (homonymous hemionopsia), vertebrobasilar insufficiency, ciliary spasm or ciliary body rotation, papilledema

painful binocular acute/transient va loss ddx

migraine, des, spk, pituitary apoplexy, papilledema (may have a headache)

monocular/binocular painless chronic va loss ddx

refractive error, cataract, oag, chronic angle closure glaucoma, k scar, optic neuropathy, des, chronic retinal disease (e.g. dmii retinopathy, armd)

monocular/binocular painful va loss chronic ddx

des, spk, post traumatic va loss (k irregularity, hyphema, ruptured globe, traumatic cataract, commotio retinae, RD, ret or vit heme, lens dislocation, traumatic optic neuropathy, cranial neuropathy, cns injury, sympathetic ophthalmia) .

distortion of va ddx common

refractive error (e.g. from anterior segment surgery, periobital or eyelid edema mass), mac disease (i.e. central serous, mac edema amd) k irregularity (keratoconus, ebmd,) k opacity, intoxication

distortion of VA less common ddx

PMD. post-refractive sx, k ectasia, topical drops (miotics/cyclos), RD, migraine (transient), hypotony, pharmacological (anticholinergic) and nonphysiological

diplopia monocular ddx

refractive error, incorrect spec alignment, kopacity or irregularity including keratoconus, cataract, iris defect (i.e. iridectomy) des, spk

less common

dislocated lens, macular disease, cns causes, nonphysiologic

diplopia binocular ddx

typically intermittent: myasthenia gravis, intermittent decompensation of phoria

constant: isolated CN palsy, orbital disease(TED, carotid sinus fistula), cavernous sinus syndrome, s/p ocular sx (residual anesthesia, displaced muscle, restriction from scleral buckle, severe aniseikonia after refractive correction), s/p trauma, congercence/divergence insufficiency, INO, vertebrobasilar artery insufficiency, other cns lesions, spectacle problem