II. Symptoms: Red Flags for CNS Cause

  1. Sudden change in vision (or worsening over hours to days)
  2. Unilateral Vision Loss with Eye Pain or pressure
  3. Vision Loss with Vomiting, severe Headache or Altered Level of Consciousness
  4. Distorted or blurry vision without ocular cause (Cornea, anterior chamber, lens, Retina)
  5. Amaurosis Fugax (Transient Monocular Blindness)
    1. Central Retinal Artery Occlusion
    2. Temporal Arteritis
  6. Binocular Diplopia (acute onset)
    1. Diplopia only with both eyes open
  7. Internuclear Ophthalmoplegia (Conjugate Gaze Palsy)
    1. Medial Longitudinal Fasciculus lesion results in discordance between CN 3 and CN 6
  8. Afferent Pupillary Defect
    1. Intact Consensual Light Reflex (but not to direct light)
    2. Ischemic Optic Neuropathy
    3. Multiple Sclerosis

III. References

  1. Marcolini in Herbert (2020) EM:Rap 20(8): 8-9

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