Unexplained Vision Loss

Abstract

When visual complaints are out of proportion to examination findings, nonorganic vision loss or a disorder of higher visual function may be suspected. However, certain ophthalmic causes of vision loss should also be considered. In this chapter, we begin by reviewing potential causes of unexplained vision loss, including refractive error, corneal disorders (e.g., keratoconus), optic neuropathy, and occult retinopathy. We next discuss clinical strategies and investigations that can help to identify certain causes of unexplained vision loss. Lastly, we discuss the clinical features, causes, and diagnostic evaluation of occult retinopathy, with a focus on conditions that cause cone photoreceptor dysfunction, such as cone dystrophy, cancer-associated retinopathy, and autoimmune retinopathy.