Amaurosis Fugax

What is the definition of 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.

What are the alternative names for Amaurosis Fugax?

Transient monocular blindness; Transient monocular visual loss; TMVL; Transient monocular visual loss; Transient binocular visual loss; TBVL; Temporary visual loss - amaurosis fugax

What are the causes for Amaurosis Fugax?

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 for 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)
• Blood vessel disease called polyarteritis nodosa
• Migraine headaches
• Brain tumor
• Head injury
• Multiple sclerosis (MS), inflammation of the nerves due to the body's immune cells attacking the nervous system
• Systemic lupus erythematosus, an autoimmune disease in which the body's immune cells attack healthy tissue throughout the body

What are the symptoms for Amaurosis Fugax?

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.

What are the current treatments for Amaurosis Fugax?

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 for 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.

What is the outlook (prognosis) for Amaurosis Fugax?

Amaurosis fugax increases your risk for stroke.

When should I contact a medical professional for Amaurosis Fugax?

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.

REFERENCES

Biller J, Ruland S, Schneck MJ. Ischemic cerebrovascular disease. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 65.

Brown GC, Sharma S, Brown MM. Ocular ischemic syndrome. In: Schachat AP, Sadda SVR, Hinton DR, Wilkinson CP, Wiedemann P, eds. Ryan's Retina. 6th ed. Philadelphia, PA: Elsevier; 2018:chap 62.

Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.