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The primary causes include post-cataract surgery, certain medications, and, less commonly, neurological or ophthalmological conditions. Post-cataract surgery is a common cause, as replacing the natural lens with a synthetic one increases exposure to blue light, leading to temporary blue-tinted vision. This effect usually resolves as the eye adapts.
The main symptom is loss of vision, with colors appearing subtly washed out in the affected eye. A pale disc is characteristic of long-standing optic neuropathy. In many cases, only one eye is affected and a person may not be aware of the loss of color vision until the examiner asks them to cover the healthy eye.
One of the first steps in diagnosing diplopia is often to see whether one of two major classifications may be eliminated. That involves blocking one eye to see which symptoms are evident in each eye alone. Persisting blurry or double vision with one eye closed is classified as monocular diplopia. [15]
Vision loss in toxic and nutritional optic neuropathy is bilateral, symmetric, painless, gradual, and progressive. Dyschromatopsia, a change in color vision, is often the first symptom. Some patients notice that certain colors, particularly red, are less bright or vivid; others have a general loss of color perception.
Major symptoms are sudden loss of vision (partial or complete), sudden blurred or "foggy" vision, and; pain on movement of the affected eye. [4] [5] [2]Many patients with optic neuritis may lose some of their color vision in the affected eye (especially red), with colors appearing subtly washed out compared to the other eye.
To minimize the risk of further visual loss in the fellow eye or the same eye, it is essential to reduce the risk factors. Common sense dictates trying to control the cardiovascular risk factors for many reasons, including protection from this happening to the second eye. Sudden vision loss should lead to an ophthalmological consultation.