Sudden Loss of Vision (Unilateral) affecting whole field of vision
Is this amaurosis fugax?
This is a transient ischaemic attack (TIA) of the retinal circulation.
Indications
- Patient is usually elderly with cardiovascular risk factors.
- Sudden onset.
- Grey/black curtain coming down or up across vision, obscuring vision, which usually disappears within 30 minutes. Vision is back to normal after an attack.
What do I find?
- Usually no ocular abnormality. May have carotid bruit.
What do I do?
- Assess risk factors for embolic stroke.
- Rare but important – GCA manifests as amaurosis fugax – worth checking ESR/CRP
Is this ocular migraine?
Indications
- Patient usually younger.
- Patient usually complains of missing patches of vision, flashes, scintillating colours or lights, typically lasting 20 minutes.
- Headache not always present
- Episodes may recur
What do I find?
- Usually nothing
- What do I do?
- Reassure as long as the vision continues to return to normal