Reduced vision
Reduced vision can be due to:
Table : Summary of the causes of reduced vision in oncology patients
| Keratitis |
Cataract |
Uveitis |
Retinal disease |
Optic nerve disease |
Visual Pathway disease |
Keratitis
Can present with visual loss and:
- red eye
- photophobia
- pain
Investigated with fluorescein staining
Causes:
- bacterial keratitis
- HSV dendritic ulcer
- dry-eye related.
Cataract
Can present with visual loss and:
- painless
- impaired red reflex
Investigated with direct ophthalmoscopy
Causes:
- steroids
- radiation
- intraocular tumour
- Busulphan
Uveitis
Can present with visual loss and:
- circumcorneal redness
- photophobia
- pain
Causes:
- infective
- leukaemic infiltration
Retinal Disease
Can present with visual loss and:
- Painless (Acute / Chronic)
Causes:
- Infective
- Leukemic infiltration
- Drugs (cisplatin, etoposide)
Optic nerve Disease
Can present with visual loss and:
- painless (Acute / Chronic)
- poor pupil response
Causes:
- leukemic infiltration
- optic nerve tumours (gliomas / meningiomas)
- radiation
- drugs (eg. vincristine)
Visual Pathways Disease (especially chiasm / optic nerve lesions)
Due to
- Intracranial tumour
- Intracranial infection
Below is a picture of bilateral posterior subcapsular cataracts secondary to prolonged systemic steroids
