Gradual Onset Vision Loss

CLINICAL DIAGNOSTIC MANUAL

Gradual onset vision loss is a common symptom that can affect individuals of all ages, although it is more frequent in the adult and elderly population. This type of vision loss develops slowly over time, making early detection and timely treatment more challenging.

The underlying cause can range from degenerative diseases to chronic inflammatory processes and optic nerve disorders. A thorough evaluation, including medical history, physical examination, and complementary tests, is essential to determine the etiology and apply appropriate treatment to prevent further vision loss and preserve the patient’s quality of life.

Condition	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Cataracts	Progressive blurred vision, glare, halos around lights, faded colours, difficulty seeing at night	History of progressive vision loss, slit-lamp examination	Slit-lamp exam showing lens opacification
Macular degeneration	Blurred central vision, distortion of straight lines (metamorphopsia), dark spots in the visual field (scotomas)	History of central vision loss, fundoscopic exam	OCT showing macular changes, fluorescein angiography
Chorioretinitis	Blurred vision, spots in the visual field, possible eye pain if active inflammation	History of infections or autoimmune diseases, inflammatory symptoms	Fundoscopic exam, OCT, fluorescein angiography
Glaucoma	Peripheral vision loss (tunnel vision), eye pain, halos around lights, increased intraocular pressure	History of elevated intraocular pressure, peripheral vision loss	Tonometry showing elevated intraocular pressure, visual field testing
Primary optic nerve atrophy	Progressive blurred vision, decreased visual acuity, changes in colour perception	History of painless progressive vision loss, optic nerve exam	Orbital MRI showing optic nerve atrophy, fundoscopic exam showing optic disc pallor