PANCE Blueprint EENT (7%)

Amaurosis fugax

Patient will present as → an 82-year-old man presents to the emergency department complaining of vision loss in his left eye. He states that it suddenly appeared as if a curtain was coming down over his left eye. It resolved after five minutes, and his vision has returned to normal. He has a history of coronary artery disease and type 2 diabetes.

Transient partial or complete loss of vision in one eye - The most common cause of amaurosis fugax is a cholesterol plaque emboli from a carotid artery plaque

  • Blockage of the central retinal artery leads to sudden, painless, monocular vision loss due to retinal hypoxia
  • Vision loss is classically described as a curtain coming down over one eye
  • Amaurosis fugax (an example of a TIA) occurs if the clot passes and the vision loss is transient. If the clot cannot pass, central retinal artery occlusion occurs

A fundus exam may reveal optic disk pallor, a cherry-red macula, and retinal edema

If it does not resolve spontaneously, treatment is recommended within an hour of the occlusion

  • Treatment involves surgical decompression, but, if unavailable, digital massage of the globe and CO2 rebreathing should be initiated in an attempt to pass the clot
Vision abnormalities (PEARLS) (Prev Lesson)
(Next Lesson) Amblyopia (lazy eye)
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