Unifying Concepts

Clinical Approach to Vision Loss

Visual loss describes temporary or permanent reduction in visual acuity and/or field. Its aetiology is diverse due to the contributions of the different neuro-ophthalmic structures (eye, optic nerve, and brain) to image formation and perception, but may be categorised into ocular causes (corneal, lenticular, vitreoretinal and macular) or optic neuropathies.

The diagnostic criteria for vision-related issues and disorders vary depending on the specific condition being assessed. Here are some common vision-related disorders and their diagnostic criteria:

1. Myopia (Nearsightedness):

  • Blurred distance vision but clear near vision.
  • Difficulty seeing objects or people in the distance.

2. Hyperopia (Farsightedness):

  • Blurred near vision but clear distance vision (in mild cases).
  • Difficulty focusing on objects up close.
  • Eye strain or headache when performing close-up tasks.

3. Astigmatism:

  • Blurred or distorted vision at all distances.
  • Difficulty seeing fine details.
  • Eye strain or discomfort.

4. Presbyopia:

  • Difficulty focusing on close-up objects, especially when reading or doing close work.
  • Need to hold reading material at arm’s length to see it clearly.
  • Blurred vision at normal reading distance.

5. Cataracts:

  • Cloudy or blurred vision.
  • Sensitivity to glare and bright lights.
  • Colors may appear faded or yellowed.

6. Glaucoma:

  • Gradual loss of peripheral (side) vision.
  • Tunnel vision in advanced stages.
  • Elevated intraocular pressure (measured during an eye exam).

7. Age-related Macular Degeneration (AMD):

  • Blurred or distorted central vision.
  • Dark or empty areas in the center of vision.
  • Difficulty recognizing faces or reading.

8. Diabetic Retinopathy:

  • Blurred or fluctuating vision.
  • Dark or empty areas in the visual field.
  • Spots or floaters.

9. Retinal Detachment:

  • Sudden onset of floaters and flashes of light.
  • A shadow or curtain over a portion of the visual field.
  • Reduced vision or loss of vision in one eye.

It’s important to note that diagnosing vision-related issues requires a comprehensive eye examination by an eye care professional, such as an optometrist or ophthalmologist. They will perform various tests, including visual acuity, refraction, and other specialized exams to determine the exact nature and severity of the vision problem. If you are experiencing any vision-related symptoms, it is essential to seek professional medical advice promptly.



  1. Raharja A, Whitefield L. Clinical approach to vision loss: a review for general physicians. Clin Med (Lond). 2022 Mar;22(2):95-99. [Medline]
  2. Borooah S, Dhillon A, Dhillon B. Gradual loss of vision in adults. BMJ. 2015 Jun 8;350:h2093. [Medline]


Created Jul 17, 2023.




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