Amaurosis fugax

Amaurosis fugax is a temporary loss of vision in one or both eyes due to a lack of blood flow to the retina . The retina is the light-sensitive layer of tissue at the back of the eyeball.

Retina

The retina is the light-sensitive layer of tissue at the back of the eyeball. Images that come through the eye's lens are focused on the retina. Th...

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Causes

Amaurosis fugax is not itself a disease. Instead, it is a sign of other disorders. Amaurosis fugax can occur from different causes. One cause is when a blood clot or a piece of plaque blocks an artery in the eye. The blood clot or plaque usually travels from a larger artery, such as the carotid artery in the neck or an artery in the heart, to an artery in the eye.

Plaque is a hard substance that forms when fat, cholesterol, and other substances build up in the walls of arteries. Risk factors include:

• Heart disease, especially irregular heartbeat
• Alcohol abuse
• Cocaine use
• Diabetes
• Family history of stroke
• High blood pressure
• High cholesterol
• Increasing age
• Smoking (people who smoke one pack a day double their risk of a stroke)

Amaurosis fugax can also occur because of other disorders such as:

• Other eye problems, such as inflammation of the optic nerve ( optic neuritis )

  Optic neuritis

  The optic nerve carries images of what the eye sees to the brain. When this nerve become swollen or inflamed, it is called optic neuritis. It may c...

  

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• Blood vessel disease called polyarteritis nodosa

  Polyarteritis nodosa

  Polyarteritis nodosa is a serious blood vessel disease. The small and medium-sized arteries become swollen and damaged.

  

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• Migraine headaches
• Brain tumor
• Head injury
• Multiple sclerosis ( MS ), inflammation of the nerves due to the body's immune cells attacking the nervous system

  MS

  Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord (central nervous system).

  

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• Systemic lupus erythematosus , an autoimmune disease in which the body's immune cells attack healthy tissue throughout the body

  Systemic lupus erythematosus

  Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the body's immune system mistakenly attacks healthy tissue. It can af...

  

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Symptoms

Symptoms include the sudden loss of vision in one or both eyes. This usually lasts for a few seconds to several minutes. Afterward, vision returns to normal. Some people describe the loss of vision as a gray or black shade coming down over the eye.

Exams and Tests

The health care provider will perform a complete eye and nervous system exam. In some cases, an eye exam will reveal a bright spot where the clot is blocking the retinal artery.

Tests that may be done include:

• Ultrasound or magnetic resonance angiography scan of the carotid artery to check for blood clots or plaque

  Ultrasound

  Carotid duplex is an ultrasound test that shows how well blood is flowing through the carotid arteries. The carotid arteries are located in the neck...

  

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  Magnetic resonance angiography scan

  Magnetic resonance angiography (MRA) is an MRI exam of the blood vessels. Unlike traditional angiography that involves placing a tube (catheter) int...

   

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• Blood tests to check cholesterol and blood sugar levels
• Tests of the heart, such as an ECG to check its electrical activity

  ECG

  An electrocardiogram (ECG) is a test that records the electrical activity of the heart.

  

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Treatment

Treatment of amaurosis fugax depends on its cause. When amaurosis fugax is due to a blood clot or plaque, the concern is to prevent a stroke. The following can help prevent a stroke:

• Avoid fatty foods and follow a healthy, low-fat diet. DO NOT drink more than 1 to 2 alcoholic drinks a day.
• Exercise regularly: 30 minutes a day if you are not overweight; 60 to 90 minutes a day if you are overweight.
• Quit smoking.
• Most people should aim for a blood pressure below 120 to 130/80 mm Hg. If you have diabetes or have had a stroke, your doctor may tell you to aim for a lower blood pressure.
• If you have diabetes, heart disease, or hardening of the arteries, your LDL "bad" cholesterol should be lower than 70 mg/dL.
• Follow your doctor's treatment plans if you have high blood pressure, diabetes, high cholesterol, or heart disease.

Your doctor may also recommend:

• No treatment. You may only need regular visits to check the health of your heart and carotid arteries.
• Aspirin, warfarin (Coumadin), or other blood-thinning drugs to lower your risk of stroke.

If a large part of the carotid artery appears blocked, carotid endarterectomy surgery is done to remove the blockage. The decision to do surgery is also based on your overall health.

Carotid endarterectomy

Carotid artery surgery is a procedure to restore proper blood flow to the brain. The carotid artery brings needed blood to your brain and face. You ...

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Outlook (Prognosis)

Amaurosis fugax increases your risk of stroke.

When to Contact a Medical Professional

Call your provider if any vision loss occurs. If symptoms last longer than a few minutes or if there are other symptoms with the vision loss, seek medical attention right away.