Amaurosis Fugax

What is Amaurosis Fugax

Amaurosis fugax is a condition in which you temporarily lose sight in one eye. The loss of vision in the affected eye may be total or partial. The vision loss usually lasts for only a few seconds or minutes before sight returns to normal.

Occasionally, it may last for several hours. This condition is caused by interruption of blood flow in the artery that supplies blood to the retina. The retina is the part of your eye that contains the nerves needed for sight.

This condition can be a warning sign of a stroke. A stroke can result in permanent vision loss or loss of other body functions.

What are the causes?

This condition is caused by a loss or interruption of blood flow to the retinal artery. Causes for the change in blood flow include:

  • Atherosclerosis, which is a buildup of cholesterol and fats (plaque). If some of that plaque breaks off and gets into the bloodstream, it can travel (embolize) to other blood vessels, such as the retinal artery.
  • Diseases of the heart valves.
  • Certain diseases of the blood, such as sickle cell anemia and leukemia.
  • Blood clotting (coagulation) disorders.
  • Inflammation of the arteries (vasculitis).
  • An irregular heartbeat, such as atrial fibrillation.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • Use of any tobacco products, including cigarettes, chewing tobacco, or electronic cigarettes.
  • Poorly controlled diabetes.
  • Heart disease.
  • High blood pressure (hypertension).
  • High cholesterol.
  • Excessive alcohol use.
  • Use of illegal drugs, especially cocaine.
  • Age. The risk increases with age.
  • Family history of stroke.

What are the signs or symptoms?

The main symptom of this condition is painless, sudden loss of vision in one eye. The vision loss often starts at the top and moves down, as if a curtain is being pulled down over your eye. This is usually followed by a quick return of vision. However, symptoms may last for several hours. It is important to seek medical care right away even if your symptoms go away.

How is this diagnosed?

This condition is diagnosed by:

  • Medical history and physical exam.
  • Eye exam.
  • Carotid ultrasound. This checks to see if plaque has built up in the carotid arteries in your neck.
  • Magnetic resonance angiography (MRA). This checks the anatomy of the carotid artery and the branches that supply the brain. It looks for areas of blockage or disease.

You may also have blood tests, an electrocardiogram (ECG) to check your heart rhythm, and an echocardiogram (ECHO) to check your heart function.

How is this treated?

Emergency treatment for this condition may involve massaging the eyeball or using certain breathing techniques to remove or ease the blockage of the retinal artery. Other treatments for this condition focuses on reducing your risk of having a stroke in the future. This may include:

  • Medicines. You may be given medicines to control high blood pressure, manage diabetes, or manage cholesterol, if needed. Blood thinning medicines may also be prescribed.
  • Procedures to either remove plaque in your carotid arteries or widen carotid arteries that have become narrow due to plaque. These may include:
    • Carotid endarterectomy. This is a surgical procedure that removes plaque from the carotid artery.
    • Carotid angioplasty and stenting. In this procedure, a thin tube with a balloon is placed into the artery and is then inflated to open the blocked portion of the artery. A stent can be placed to keep that section of the artery open.
  • Lifestyle changes to reduce your risk of having a stroke. These can include changing your diet and getting enough exercise.

It is possible that you may not need any immediate treatment.

Follow these instructions at home:

Eating and drinking

  • Eat a diet that includes five or more servings of fruits and vegetables each day. This may reduce the risk of stroke. Certain diets may be recommended to deal with high blood pressure, high cholesterol, diabetes, or obesity.
  • A diet that is low in sodium is recommended to manage high blood pressure.
  • A high-fiber diet that is low in saturated fat, transfat, and cholesterol may control cholesterol levels.
  • A low-carbohydrate, low-sugar diet is recommended to manage diabetes.
  • A reduced-calorie diet that is low in sodium, saturated fat, transfat, and cholesterol is recommended to manage obesity.

Lifestyle

  • Maintain a healthy weight.
  • Stay physically active. It is recommended that you get at least 30 minutes of activity on most or all days.
  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
  • Do notabuse drugs.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider. Follow the directions carefully. Make sure that you understand all of your medicine instructions. Medicines may be used to control the risk factors of stroke.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You lose vision in one eye or both eyes.

Get help right away if:

  • You have chest pain or an irregular heartbeat.
  • You have any symptoms of stroke. The acronym BEFAST is an easy way to remember the main warning signs of stroke.
    • B = Balance problems. Signs include dizziness, sudden trouble walking, or loss of balance.
    • E = Eye problems. This includes trouble seeing or a sudden change in vision.
    • F = Face changes. This includes sudden weakness or numbness of the face, or the face or eyelid drooping to one side.
    • A = Arm weakness or numbness. This happens suddenly and usually on one side of the body.
    • S = Speech problems. This includes trouble speaking or trouble understanding.
    • T = Time. Time to call 911 or seek emergency care. Do not wait to see if symptoms will go away. Make note of the time your symptoms started.
  • Other signs of stroke may include:
    • A sudden, severe headache with no known cause.
    • Nausea or vomiting.
    • Seizure.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services

Summary

  • Amaurosis fugax is a condition in which you temporarily lose your sight in one eye.
  • This condition can be a warning sign of a stroke. A stroke can result in permanent vision loss or loss of other body functions.
  • Seek medical care right away even if your symptoms go away.
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