Blurred vision

Blurred vision

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

• Common ophthalmic symptom
• Vision is less sharp and an inability to see small details exists
• Alterations of the optical surfaces or media for which the visual axis travels typically cause blurred vision
• Refractive errors cause the majority of blurred vision complaints.
• Most can be corrected with glasses

Differential Diagnosis

In alphabetical order.

3-Quinuclidinyl benzilate Acetazolamide Acetohexamide Acute angle-closure glaucoma Acute posterior multifocal placoid pigment epitheliopathy Aldicarb Alfuzosin Aliskiren Alpha-Methyltryptamine Amantadine Amiodarone Oral Amitriptyline Amphotericin B Injection Amprenavir Anastrozole Anesthesia Anticholinergic Antihistamine Aripiprazole Asthenopia Astigmatism (eye) Atenolol Atropine Avacor Azelastine Ophthalmic Belladonna Alkaloid Combinations and Phenobarbital Benzatropine Benzodiazepine Benztropine Mesylate Oral Bepridil Bimatoprost Biperiden Bismuth Subsalicylate, Metronidazole, and Tetracycline Combination Bisoprolol Bortezomib Bosentan Botulism Brimonidine Ophthalmic Brinzolamide Ophthalmic Bupivacaine Buprenorphine Sublingual and Buprenorphine and Naloxone Sublingual Buspirone Butanethiol Carbamazepine Carbon dioxide narcosis Carvedilol Cataracts Central serous retinopathy Cerebral arteriovenous malformation Cetuximab Injection Cevimeline Chiasma syndrome Chlordiazepoxide Chloroquine Chlorpropamide Clitocybe dealbata Clomiphene Clonazepam Clorazepate Coats disease Colistimethate Injection Computer vision syndrome Congenital disorders Conjunctivitis Convergence insufficiency Corneal abrasion Corneal irregularity or abrasion Cryptococcosis Cyclizine Cyclosporine Ophthalmic Cysticercosis Cytarabine Cytomegalovirus retinitis Dapiprazole Ophthalmic Darifenacin Darunavir Deadly nightshade Desipramine Dexmethylphenidate Dextroamphetamine and Amphetamine Dextromethorphan Diabetes insipidus Diabetes mellitus Diabetic retinopathy Diazepam Diazinon Diclofenac Ophthalmic Dicyclomine Didanosine Diethylcathinone Diethylpropion Difluoroethane Digoxin Dihydroergotamine Injection and Nasal Spray Diphenhydramine Dipivefrin Ophthalmic Disopyramide Disulfiram Dorzolamide and Timolol Ophthalmic Dosulepin hydrochloride Doxepin Dry eye, poor tear film Duloxetine Enfuvirtide Injection Eplerenone Ergoloid Mesylates Esomeprazole Estazolam Ethcathinone Ethchlorvynol Etodolac Exenatide Injection

Extraocular muscle paralysis Fatigue Fenoprofen Fexofenadine and Pseudoephedrine Flavoxate Fluphenazine Fluticasone and Salmeterol Oral Inhalation Fosamprenavir Fuchs' dystrophy Fungal keratitis Furosemide Gabapentin Gamma-Hydroxybutyric acid Gatifloxacin Gemfibrozil Glaucoma Glimepiride Glipizide Glyburide Glycopyrrolate Granisetron Graves ophthalmopathy Guanfacine H1 antihistamine Hawaiian baby woodrose Head trauma HELLP syndrome Henipavirus Homatropine Hwabyeong Hydrocortisone, Neomycin, and Polymyxin Hydroxychloroquine Hyoscyamine Hyperbaric medicine Hypercoagulation Hyperglycemia Hyperopia Hypertension Hyperviscosity Hypervitaminosis A Hypoglycemia Imipramine Indapamide Indometacin Indomethacin Infection, inflammation or injury of cornea Infliximab Injection Insulin Aspart (rDNA Origin) Injection Insulin lispro injection Insulinoma Intraocular lymphoma Ipratropium Oral Inhalation Iritis Isocarboxazid Isosorbide Ivabradine Ketorolac Ophthalmic Ketotifen Ophthalmic Lamotrigine Lanthanum Levalbuterol Oral Inhalation Levobupivacaine Lidocaine Transdermal Lisinopril and Hydrochlorothiazide Lodoxamide Ophthalmic Lofepramine Lomotil Loprazolam Lorazepam Loxapine Oral Machado-Joseph disease Macular degeneration Macular disease Meclofenamate Medroxyprogesterone Mefenamic acid Megestrol Meperidine Metformin Methocarbamol Oral Methotrexate Methylphenidate Transdermal Metipranolol Ophthalmic Miconazole Injection Miglitol Migraine Minocycline Oral Minoxidil Moclobemide Monocrotophos Moricizine Morphine Oral Motofen Moxifloxacin ophthalmic Multiple sclerosis Muscarine Mushroom poisoning Myasthenia Nalbuphine Naltrexone Nateglinide oral Nedocromil ophthalmic Nefazodone Nepafenac ophthalmic Neurocardiogenic Syncope Neuroglycopenia Niacin Nitroglycerin ointment Norethindrone Nortriptyline Ocular media opacity Oculotect Ofloxacin ophthalmic Olanzapine

Olmesartan Olopatadine ophthalmic Omeprazole Ondansetron injection Optic neuritis Ornithine translocase deficiency Orphenadrine Orthostatic hypotension Orthostatic intolerance Oxazepam Oxcarbazepine Oxybutynin Paliperidone Pamidronate injection Panic disorder Parasites Peginterferon alfa-2a Pentamidine Isethionate Injection Pergolide Periphlebitis retinae Perphenazine oral Phentermine Phenytoin oral Pilocarpine ophthalmic Pimozide Pioglitazone PMA Post-concussion syndrome Prazepam Prazosin and polythiazide Prediabetes Prednisolone Pregabalin Presbyopia Primaquine Primidone Procyclidine Prograf Prolonged exposure to the outdoors Promethazine Propafenone Propantheline Protriptyline Pyridostigmine Quetiapine Quinidine Oral Rasagiline Refractive error Reiter's Syndrome Repaglinide Retinal detachment Risperidone Rituximab injection Rivastigmine Rogaine (drug) Ropivacaine Rosiglitazone Salmeterol oral inhalation Scopolamine Seizure disorders Sildenafil Sleep deprivation Sodium oxybate Solifenacin Spironolactone SSRI discontinuation syndrome Subdural hematoma Sulindac Tacrolimus Tadalafil Tamsulosin Tartrazine Tegaserod Telithromycin Temazepam Temik Temporal arteritis Terazosin Tetrahydrozoline Ophthalmic Thioridazine Thiothixene Oral Thygeson's superficial punctate keratopathy Tiludronate Tiotropium Oral Inhalation Tipranavir Tobramycin Ophthalmic Tolazamide Tolbutamide Topiramate Trachoma Tranylcypromine Traumatic brain injury Travoprost Ophthalmic Trazodone Triazolam Tricyclic antidepressant Trifluoperazine Oral Trihexyphenidyl Trimethobenzamide Trimipramine Trospium Uveitis Valproic Acid Vardenafil Vasculopathy Vertebrobasilar insufficiency Verteporfin Viral Voriconazole Vorinostat Ziprasidone Zolpidem Zopiclone

Diagnosis

History and Symptoms

• Detailed history important, including the following:

  • Duration of symptoms
  • Progression of symptoms
  • Near or far sighted
  • Permanent or transient
  • Binocular or uniocular

• Past medical history
• Associated symptoms

Physical Examination

Eyes

• Complete ophthalmologic exam including:

  • Slit lamp examination
  • Dilated fundus exam
  • Visual acuity
  • Improvement of vision with pinhole
  • Dry or irritated eyes

Ear Nose and Throat

Palpate the temporal area to determine if there is pain in the temporal area to suggest temporal arteritis

• Neurologic exam if necessary

Laboratory Findings

• Complete blood count (CBC)
• Fasting or random blood sugar

  • Repeat glucose (if initial glucose is elevated)

• Prothrombin time (PT)
• Partial thromboplastin time (PTT)

Electrolyte and Biomarker Studies

Check erythrocyte sedimentation rate to rule out temporal arteritis

Other Imaging Findings

• Electroencephalogram (EEG) if seizures are suspected

Treatment

• Treat underlying pathologies
• For dry eyes, lubrication
• Appropriate treatment for hyperviscosity

Pharmacotherapy

Acute Pharmacotherapies

• Antiseizure prophylaxis (seizure disorders)

Surgery and Device Based Therapy

• Glasses or contact lenses for blurred vision due to refractive errors
• Possible surgical repair for retinal detachment
• Temporal artery biopsy may be needed

Acknowledgements

The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

List of contributors:

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