The main symptoms of eye diseases include visual impairment, abnormal sensations, and abnormal appearance. These symptoms and their severity are helpful for diagnosing ocular conditions.
Visual Impairment
Symptoms related to visual impairment include sudden or gradual vision loss, blurriness in either distance or near vision, distorted or smaller images, changes in color perception, night blindness, double vision, visual field defects, and fixed or floating shadows in the field of vision. Based on the duration of visual impairment, the speed of onset, and whether it is accompanied by eye pain, the condition can be categorized as follows:
Transient Vision Loss or Decline
Refers to sudden vision loss that recovers within a short time. It is commonly seen in ischemic changes in the central nervous system, such as orthostatic hypotension, vascular spasms (e.g., central retinal artery spasm, vertebrobasilar insufficiency). It may also occur in cases of psychogenic blackouts, hysteria, excessive fatigue, or migraines. For some patients, it may signal a serious underlying ocular condition, including central retinal vascular occlusion or central nervous system lesions.
Acute Vision Decline
Refers to sudden and often profound deterioration of vision. Without pain, it can occur in conditions like retinal arterial or venous occlusion, ischemic optic neuropathy, vitreous hemorrhage, retinal detachment, or optic neuritis. With pain, it may be associated with acute angle-closure glaucoma, uveitis, keratitis, endophthalmitis, or retrobulbar optic neuritis, which can sometimes present with pain during eye movement.
Progressive Vision Decline
Refers to mild initial vision loss that gradually worsens. It is commonly associated with age-related eye conditions, such as cataracts, primary open-angle glaucoma, macular degeneration, and other retinal diseases.
Abnormal Sensations
Symptoms include eye pain (stabbing pain, distending pain), photophobia, tearing, dryness, itching, and foreign body sensations. Eye pain, along with photophobia and tearing, is often caused by acute inflammatory conditions such as keratoconjunctivitis, iridocyclitis, or orbital cellulitis, as well as elevated intraocular pressure or eye trauma. Dryness, itching, and foreign body sensations are commonly seen in chronic inflammation or dry eye syndrome.
Abnormal Appearance
Symptoms include abnormalities in color, shape, position, and movement of the eyes. Redness of the eye is commonly seen in acute inflammation, while a whitish appearance of the eye can indicate leukocoria, cataracts, corneal opacities, or other conditions. Abnormalities in shape may include incomplete eyelid closure, ptosis, or the presence of neoplasms. Positional abnormalities include exophthalmos or eyeball atrophy. Movement abnormalities include nystagmus and strabismus.