Vision loss
Overview
 
Vision loss or visual loss is the absence of vision
Visual perception
Visual perception is the ability to interpret information and surroundings from the effects of visible light reaching the eye. The resulting perception is also known as eyesight, sight, or vision...

 where it existed before, which can happen either acutely (i.e. abruptly) or chronically
Chronic (medicine)
A chronic disease is a disease or other human health condition that is persistent or long-lasting in nature. The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic diseases include asthma, cancer, diabetes and HIV/AIDS.In medicine, the...

 (i.e. over a long period of time).
Various scales have been developed to describe the extent of vision and vision loss based on visual acuity
Visual acuity
Visual acuity is acuteness or clearness of vision, which is dependent on the sharpness of the retinal focus within the eye and the sensitivity of the interpretative faculty of the brain....

. Early editions of the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

's ICD
ICD
The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...

 described a simple distinction between "legally sighted" and "legally blind". The ICD-9 released in 1979 introduced the smallest continuous scale which consisted of three tiers: normal vision, low vision
Low vision
Low vision is a subspecialty within the professions of optometry and ophthalmology dealing with individuals who have reduced vision even when using the best possible spectacle or contact lens correction available. It can be a result of either congenital disease Low vision is a subspecialty within...

, and blindness
Blindness
Blindness is the condition of lacking visual perception due to physiological or neurological factors.Various scales have been developed to describe the extent of vision loss and define blindness...

.
Acute visual loss may be dramatic in presentation.
It may be caused by media opacities, retina
Retina
The vertebrate retina is a light-sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera. Light striking the retina initiates a cascade of chemical and electrical...

l disease, optic nerve
Optic nerve
The optic nerve, also called cranial nerve 2, transmits visual information from the retina to the brain. Derived from the embryonic retinal ganglion cell, a diverticulum located in the diencephalon, the optic nerve doesn't regenerate after transection.-Anatomy:The optic nerve is the second of...

 disease, visual pathway disorders, or functional disorders, or it may be in fact an acute discovery of chronic visual loss.
Opacities of the clear refractive media of the eye
Human eye
The human eye is an organ which reacts to light for several purposes. As a conscious sense organ, the eye allows vision. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth...

 such as the cornea
Cornea
The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Together with the lens, the cornea refracts light, with the cornea accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is...

, anterior chamber, lens
Lens (anatomy)
The crystalline lens is a transparent, biconvex structure in the eye that, along with the cornea, helps to refract light to be focused on the retina. The lens, by changing shape, functions to change the focal distance of the eye so that it can focus on objects at various distances, thus allowing a...

, and vitreous humor may cause acute visual loss as manifested by blurry vision or reduced visual acuity
Visual acuity
Visual acuity is acuteness or clearness of vision, which is dependent on the sharpness of the retinal focus within the eye and the sensitivity of the interpretative faculty of the brain....

.
While pupillary reflex
Pupillary reflex
The pupillary light reflex is a reflex that controls the diameter of the pupil, in response to the intensity of light that falls on the retina of the eye, thereby assisting in adaptation to various levels of darkness and light, in addition to retinal sensitivity...

es may be affected, these conditions generally do not cause a relative afferent pupillary defect.

Causes of media opacity include corneal edema, hyphema
Hyphema
Hyphema is blood in the front chamber of the eye. It may appear as a reddish tinge, or it may appear as a small pool of blood at the bottom of the iris or in the cornea.-Causes:...

, cataract
Cataract
A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light...

 and vitreous hemorrhage
Vitreous Hemorrhage
Vitreous Hemorrhage is the extravasation of blood into the areas in and around the vitreous humor of the eye. The vitreous humor is the clear gel that fills the space between the lens and the retina of the eye...

.
Retinal diseases may cause sudden visual loss.
Because the retina is being affected, there is usually a concomitant relative afferent pupillary defect.
Conditions that affect or destroy the retina include retinal detachment
Retinal detachment
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency.The retina is a...

; macula
Macula
The macula or macula lutea is an oval-shaped highly pigmented yellow spot near the center of the retina of the human eye. It has a diameter of around 5 mm and is often histologically defined as having two or more layers of ganglion cells...

r disease (e.g., macular degeneration
Macular degeneration
Age-related macular degeneration is a medical condition which usually affects older adults and results in a loss of vision in the center of the visual field because of damage to the retina. It occurs in “dry” and “wet” forms. It is a major cause of blindness and visual impairment in older adults...

); and retinal vascular occlusions, the most important of which is central retinal artery occlusion.
Diseases which affect the optic nerve may cause acute visual loss.
Signs include an abnormal pupillary reflex, with an afferent pupillary defect when the optic nerve disease is unilateral.
 
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