Determine monocular vs binocular
Evaluate for visual field defects
Evaluate visual acuity
Assess cranial nerves
Multiple cranial nerve involvement suggests an intracranial process or cavernous sinus involvement
Check extraocular muscle function
Entrapment will show extraocular muscle restriction with extremes of gaze
Sudden painful or non painful onset suggest a vascular cause such as thrombosis, dissection, ischemia, or vasculitis
Other neuro deficits should raise suspicion for a CVA or MS
Systemic illness is more likely with meningitis involving the brainstem
Bilateral symptoms are more likely with neuromuscular problems such as Miller Fischer syndrome, botulism, or myasthenia gravis
Multiple cranial nerve involvement suggests an intracranial process or cavernous sinus involvement
Entrapment will show extraocular muscle restriction with extremes of gaze
Diplopia
Cataract
Tinnitus
Lens dislocation
Dizziness
Macular disruption
Cataracts
Basilar Artery Thrombosis