Dalam menentukan penyebab kebutaan yang mendadak memiliki

Sudden visual loss has an extensive differential diagnoses. Determining the

etiology is guided by variables such as patient age, lateralization of symptoms, time
course of vision loss, and associated symptoms, including the presence or absence of
pain. In general, monocular vision loss indicates an ocular problem or a problem anterior
to the optic chiasm, and the vision loss may respect the horizontal midline. Binocular
vision loss is usually cerebral in origin and often respects the vertical midline. Sudden-
onset painless vision loss is often ischemic in origin. However, if accompanied by
headache, sudden vision loss can result from giant cell arteritis (GCA) and pituitary
apoplexy. Vision loss with pain upon eye movement in young women should prompt
consideration of optic neuritis.

Symptoms of vision loss have been described as a gradually descending gray-black

curtain or as blurring, fogging, or dimming of vision and can last a few minutes to hours.
The presentation of vision loss ranges from a single episode to multiple episodes per day;
recurrences may continue for years and frequently occur over seconds to hours.

Numerous causes of sudden visual loss are recognized. Vision loss with positive scotoma
may be seen with migraine. Vision loss with negative scotoma may be seen with
amaurosis fugax. Ischemia, often via mechanical obstruction, can affect any aspect of the
visual system and commonly occurs among individuals with atherosclerotic disease, such
as coronary artery disease and peripheral vascular disease. Sudden changes in refractive
error may be associated with diabetes mellitus or shallowing of the anterior chamber due
to certain medications, including topiramate. Corneal edema due to endothelial
decompensation or hydrops may cause abrupt vision loss. Cataracts encroaching on the
visual axis may be interpreted by patients as sudden vision loss.

Other etiologies of sudden visual loss include infection/inflammation, vitreous

hemorrhage, retinal detachment, GCA and other vasculitis, trauma, and idiopathic causes.