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Peripheral vision loss Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Peripheral vision loss. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you noticed the peripheral vision loss?

    Why: to determine if acute or chronic.

  2. Is it unilateral or bilateral?

    Why: if unilateral would suggest a local eye cause such as glaucoma. Bilateral peripheral vision loss can occur with glaucoma, retinitis pigmentosa, pituitary tumors, meningioma of the dura (tumor of the membrane covering the brain), brain aneurysm, craniopharyngioma or quinine toxicity.

  3. Is it transient or constant?

    Why: if transient may suggest migraine.

  4. Was it sudden in onset?

    Why: may suggest migraine, glaucoma.

  5. Drug or alcohol ingestion?

    Why: e.g. quinine or chloroquine may be responsible.

  6. Past medical history?

    Why: e.g. diabetes increases risk of glaucoma; migraine can cause transient peripheral vision loss.

  7. Medications?

    Why: some medications can cause peripheral vision loss e.g. chloroquine or quinine may be toxic to the eyes.

  8. Family history?

    Why: of Diabetes, Glaucoma, Retinitis pigmentosa, migraine.

  9. Colored haloes around lights?

    Why: suggests glaucoma.

  10. Zigzag lines?

    Why: suggests migraine.

  11. Vision worse at night or in dim light?

    Why: suggests retinitis pigmentosa, syphilitic retinitis.

  12. Headache?

    Why: suggests migraine or pituitary tumor.

Conditions listing medical symptoms: Peripheral vision loss:

The following list of conditions have 'Peripheral vision loss' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Peripheral vision loss or choose View All.

View All B C G H M O P R S T U

Conditions listing medical complications: Peripheral vision loss:

The following list of medical conditions have 'Peripheral vision loss' or similar listed as a medical complication in our database.


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