Amaurosis Fugax

Transient monocular blindness is a common symptom which carries important diagnostic and therapeutic implications. It is most commonly due to retinal embolism which is sometimes recognizable ophthalmoscopically. Bright, glinting emboli indicate the presence of cholesterol, while whitish homogeneous masses in the arterioles represent platelet aggregates. The usual source of emboli is atheroma at the origin of the internal carotid artery. Untreated, 16% of patients develop permanent visual loss or hemiplegia. Neither the character of the ocular symptoms, nor the frequency, duration nor total number of episodes provides a reliable guide to prognosis. However, associated or independent transient hemisphere symptoms indicate an increased risk of hemiplegia.