Loss of vision

Iris

Anterior uveitis
red eye, pain, photophobia, poorly reacting/irregular size pupil, 'circumlimbial' pattern of injection

Acute angle closure glaucoma
eye pain, photophobia, change in pupil shape/size and loss of vision

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Vitreous

Vitreous haemorrhage - diabetic or retinal tear

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Retina

Wet AMD - requires rapid referral after onset of symptoms

Retinal detachment - usually history of myopia or intraocular surgery; usually painless and can present with flashes of light, floaters and a feeling of dots, usually noticed as a 'shadow' or 'curtain' spreading across the field of vision.; loss of red reflex

Retinal artery/vein occlusion - often reported on waking

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Optic Nerve

Optic neuritis- unilateral sudden vision loss in a patient aged 20–50 years, associated with retrobulbar pain, central scotoma, loss of colour vision and relative afferent papillary defect (when a light is swung from eye to eye the affected pupil dilates when light is shone into it) and pain that is exacerbated by eye movement; associated with multiple sclerosis

Ischaemic optic neuropathy - Giant cell arteritis: headache, temple tenderness, vague malaise, muscle aches, jaw claudication, anorexia and weight loss, blurred vision; 60 mg prednisolone (1 mg/kg); overlap with polymyalgia rheumatica.

Embolic occlusion of retinal vessels: amaurosis fugax transient visual loss indicates emboli

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