Visual disturbance and abnormal eye movement
Localising visual loss and diplopia, the emergencies (retinal artery occlusion, GCA, pupil-involving third nerve palsy, pituitary apoplexy), myasthenia and thyroid eye disease, and the Austroads vision standards.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- First decide: one eye or both? loss of vision or double vision? sudden or gradual? painful or painless?
- Measure acuity (with pinhole) and test fields, pupils and fundi in everyone.
- Sudden painless monocular loss is retinal ischaemia until proven otherwise: stroke pathway, and GCA bloods if over 50.
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Sources
- Therapeutic Guidelines: OphthalmologyAU/NZTherapeutic Guidelines Limited
- Assessing Fitness to Drive (AP-G56), Vision and eye disordersAU/NZAustroads and National Transport Commission, 2022
- Australian and New Zealand Living Clinical Guidelines for Stroke ManagementAU/NZStroke Foundation, Living guideline
- Management of central retinal artery occlusion: a scientific statement from the American Heart AssociationAmerican Heart Association (Stroke), 2021
- Intravenous alteplase versus oral aspirin for acute central retinal artery occlusion within 4.5 h of severe vision loss (THEIA)The Lancet Neurology, 2025
- A randomized trial of tenecteplase in acute central retinal artery occlusion (TenCRAOS)New England Journal of Medicine, 2026
- The 2021 European Group on Graves' Orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathyEuropean Journal of Endocrinology, 2021
- EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 updateEULAR (Annals of the Rheumatic Diseases), 2023, published 2024
- Teprotumumab (Tepezza): PBS medicine statusAU/NZPharmaceutical Benefits Scheme, Updated 31 October 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback