Transient Monocular Visual Loss - 18/08/11

Doi : 10.1016/j.ajo.2005.04.020

Valérie Biousse, MD ^a,^⁎ , Jonathan D. Trobe, MD ^b
^a Emory University School of Medicine, Atlanta, Georgia
^b University of Michigan Medical School, Ann Arbor, Michigan

Inquiries to Valérie Biousse, MD, Neuro-ophthalmology Unit, Emory Eye Center, 1365-B Clifton Road, Atlanta, GA 30322; fax: 404-778-4849

Résumé

Purpose

To provide a practical update on the diagnosis and management of transient monocular visual loss (TMVL).

Design

Perspective.

Methods

Review of the literature.

Results

TMVL is an important clinical symptom. It has numerous causes but most often results from transient retinal ischemia. It may herald permanent visual loss or a devastating stroke, and patients with TMVL should be evaluated urgently. A practical approach to the evaluation of the patient with TMVL must be based on the patient’s age and the suspected underlying etiology. In the older patient, tests should be performed to investigate giant cell arteritis, atherosclerotic large vessel disease, and cardiac abnormalities. In the younger patient, TMVL is usually benign and the evaluation should be tailored to the particular clinical setting.

Conclusions

Specific prevention strategies are tailored to the most likely cause of TMVL and the patient’s underlying risk factors. Prevention of a future event should begin in the ophthalmologist’s office with education and aggressive treatment of artherosclerotic risk factors.

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Plan

This study was supported in part by National Institutes of Health CORE Grant P30-EY06360 (Department of Ophthalmology); and a departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc, New York, New York.