Sudden Loss of Vision

Key points

• • Painless causes: central retinal artery or vein occlusion, vitreous haemorrhage, retinal detachment, ischaemic optic neuropathy.
• • Painful causes: acute angle-closure glaucoma, optic neuritis and giant cell arteritis.
• • Central retinal artery occlusion is a 'stroke of the eye' - a pale retina with a cherry-red spot.
• • In patients over 50, consider giant cell arteritis; obtain inflammatory markers and start steroids urgently when it is suspected, with temporal artery biopsy or appropriate imaging used to confirm the diagnosis according to local protocol.