Amaurosis fugax - Revision history

Oflaherty: /* Evaluation */

2025-07-13T17:38:07Z

Evaluation

← Older revision		Revision as of 17:38, 13 July 2025
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	*[[brain MRI\|MRI]] (if suspicion for [[CVA]], [[Multiple Sclerosis]], or undifferentiated [[intracranial mass\|mass lesion]])		*[[brain MRI\|MRI]] (if suspicion for [[CVA]], [[Multiple Sclerosis]], or undifferentiated [[intracranial mass\|mass lesion]])
	*[[Ocular ultrasound]] (evaluate for [[retinal detachment]] or [[retinal hemorrhage\|hemorrhage]])		*[[Ocular ultrasound]] (evaluate for [[retinal detachment]] or [[retinal hemorrhage\|hemorrhage]])
			*[[ESR/CRP]] (evaluate for [[Temporal Arteritis]]

	==Management==		==Management==

Rossdonaldson1: /* Background */

2020-12-16T20:49:04Z

Background

← Older revision		Revision as of 20:49, 16 December 2020
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	==Background==		==Background==
			[[File:Schematic diagram of the human eye en.png\|thumb\|Eye anatomy.]]
	*Transient painless [[visual loss]] caused by either circulatory, ocular or a neurologic condition. Vision loss can last a few seconds to minutes.<ref>Fisher CM et al. "'Transient monocular blindness' versus 'amaurosis fugax'". Neurology. December 1989. 39 (12): 1622–4. doi:10.1212/wnl.39.12.1622. PMID 2685658</ref>		*Transient painless [[visual loss]] caused by either circulatory, ocular or a neurologic condition. Vision loss can last a few seconds to minutes.<ref>Fisher CM et al. "'Transient monocular blindness' versus 'amaurosis fugax'". Neurology. December 1989. 39 (12): 1622–4. doi:10.1212/wnl.39.12.1622. PMID 2685658</ref>
	*Fugax is greek for "fleeing"		*Fugax is greek for "fleeing"
	*Greatest suspicion in assessing these patients should be to evaluation for acute [[stroke]] and embolic phenomenon as that will carry the greatest mortality<ref>Benavente O et al. "Prognosis after transient monocular blindness associated with carotid-artery stenosis". N. Engl. J. Med. 345 (15): 1084–90. doi:10.1056/NEJMoa002994. PMID 11596587 [http://www.nejm.org/doi/pdf/10.1056/NEJMoa002994 Full text]</ref>		*Greatest suspicion in assessing these patients should be to evaluation for acute [[stroke]] and embolic phenomenon as that will carry the greatest mortality<ref>Benavente O et al. "Prognosis after transient monocular blindness associated with carotid-artery stenosis". N. Engl. J. Med. 345 (15): 1084–90. doi:10.1056/NEJMoa002994. PMID 11596587 [http://www.nejm.org/doi/pdf/10.1056/NEJMoa002994 Full text]</ref>

	==Clinical Features==		==Clinical Features==
	*Patients report complete blackening of vision.		*Patients report complete blackening of vision.

Rossdonaldson1: /* See Also */

2020-09-26T18:18:14Z

Rossdonaldson1: /* See Also */

2020-09-26T18:17:56Z

ClaireLewis: /* Evaluation */

2019-10-02T01:01:39Z

Evaluation

← Older revision		Revision as of 01:01, 2 October 2019
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	*CBC (to assess for severe anemia or thrombocytosis)		*CBC (to assess for severe anemia or thrombocytosis)
	*INR (if patient is anticoagulated)		*INR (if patient is anticoagulated)
	*MRI (if suspicion for [[CVA]], [[Multiple Sclerosis]], or undifferentiated mass lesion)		*[[brain MRI\|MRI]] (if suspicion for [[CVA]], [[Multiple Sclerosis]], or undifferentiated [[intracranial mass\|mass lesion]])
	*[[Ocular ultrasound]] (evaluate for retinal detachment or hemorrhage)		*[[Ocular ultrasound]] (evaluate for [[retinal detachment]] or [[retinal hemorrhage\|hemorrhage]])

	==Management==		==Management==

ClaireLewis: /* Differential Diagnosis */

2019-09-14T14:10:50Z

Differential Diagnosis

← Older revision		Revision as of 14:10, 14 September 2019
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	===Idiopathic===		===Idiopathic===
	*Diagnosis of exclusion		*Diagnosis of exclusion

			{{Acute vision loss noninflamed DDX}}

	==Evaluation==		==Evaluation==

ClaireLewis at 14:09, 14 September 2019

2019-09-14T14:09:53Z

← Older revision		Revision as of 14:09, 14 September 2019
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	==Background==		==Background==
	*Transient painless visual loss caused by either circulatory, ocular or a neurologic condition. Vision loss can last a few seconds to minutes.<ref>Fisher CM et al. "'Transient monocular blindness' versus 'amaurosis fugax'". Neurology. December 1989. 39 (12): 1622–4. doi:10.1212/wnl.39.12.1622. PMID 2685658</ref>		*Transient painless [[visual loss]] caused by either circulatory, ocular or a neurologic condition. Vision loss can last a few seconds to minutes.<ref>Fisher CM et al. "'Transient monocular blindness' versus 'amaurosis fugax'". Neurology. December 1989. 39 (12): 1622–4. doi:10.1212/wnl.39.12.1622. PMID 2685658</ref>
	*Fugax is greek for "fleeing"		*Fugax is greek for "fleeing"
	*Greatest suspicion in assessing these patients should be to evaluation for acute stroke and embolic phenomenon as that will carry the greatest mortality<ref>Benavente O et al. "Prognosis after transient monocular blindness associated with carotid-artery stenosis". N. Engl. J. Med. 345 (15): 1084–90. doi:10.1056/NEJMoa002994. PMID 11596587 [http://www.nejm.org/doi/pdf/10.1056/NEJMoa002994 Full text]</ref>		*Greatest suspicion in assessing these patients should be to evaluation for acute [[stroke]] and embolic phenomenon as that will carry the greatest mortality<ref>Benavente O et al. "Prognosis after transient monocular blindness associated with carotid-artery stenosis". N. Engl. J. Med. 345 (15): 1084–90. doi:10.1056/NEJMoa002994. PMID 11596587 [http://www.nejm.org/doi/pdf/10.1056/NEJMoa002994 Full text]</ref>
	==Clinical Features==		==Clinical Features==
	*Patients report complete blackening of vision.		*Patients report complete blackening of vision.

	==Differential Diagnosis==		==Differential Diagnosis==
	''Causes are divided into '''embolic''', '''hemodynamic''', '''ocular''', '''neurologic''', and '''idiopathic''' <ref> "Current management of amaurosis fugax. The Amaurosis Fugax Study Group". Stroke 21 (2): 201–8. February 1990. doi:10.1161/01.STR.21.2.201. PMID 2406992 [http://stroke.ahajournals.org/content/21/2/201.full.pdf Full Text]</ref>		''Causes are divided into '''embolic''', '''hemodynamic''', '''ocular''', '''neurologic''', and '''idiopathic''' <ref> "Current management of amaurosis fugax. The Amaurosis Fugax Study Group". Stroke 21 (2): 201–8. February 1990. doi:10.1161/01.STR.21.2.201. PMID 2406992 [http://stroke.ahajournals.org/content/21/2/201.full.pdf Full Text]</ref>
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	**[[Central Retinal Vein Occlusion (CRVO)]]		**[[Central Retinal Vein Occlusion (CRVO)]]
	*Drug abuse-related intravascular emboli		*Drug abuse-related intravascular emboli
	===Hemodynamic===		===Vascular/Hemodynamic===
	*[[Carotid stenosis]]		*[[Carotid stenosis]]
	*Arteritis ([[Temporal arteritis]], [[Takayasu arteritis]])		*Arteritis ([[Temporal arteritis]], [[Takayasu arteritis]])
	*Hypoperfusion ([[CHF]], [[Hyperviscosity syndrome]], ~~hyper coagulable~~ state)<ref>Bacigalupi M et al. "Amaurosis Fugax-A Clinical Review". The Internet Journal of Allied Health Sciences and Practice. 2006 4 (2): 1–6.[http://ijahsp.nova.edu/articles/vol4num2/Bacigalupi.pdf Fulltext]</ref><ref>Mundall J, Quintero P, Von Kaulla KN, Harmon R, Austin J (March 1972). "Transient monocular blindness and increased platelet aggregability treated with aspirin. A case report". Neurology 22 (3): 280–5.</ref>		*Hypoperfusion ([[CHF]], [[Hyperviscosity syndrome]], hypercoagulable state)<ref>Bacigalupi M et al. "Amaurosis Fugax-A Clinical Review". The Internet Journal of Allied Health Sciences and Practice. 2006 4 (2): 1–6.[http://ijahsp.nova.edu/articles/vol4num2/Bacigalupi.pdf Fulltext]</ref><ref>Mundall J, Quintero P, Von Kaulla KN, Harmon R, Austin J (March 1972). "Transient monocular blindness and increased platelet aggregability treated with aspirin. A case report". Neurology 22 (3): 280–5.</ref>

	===Ocular===		===Ocular===
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	===Idiopathic===		===Idiopathic===
	*Diagnosis of exclusion		*Diagnosis of exclusion

	==Evaluation==		==Evaluation==
	''Workup will focus will vary significantly based on the differential and clinical presentation''		''Workup will focus will vary significantly based on the differential and clinical presentation''
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	In general it includes:		In general it includes:
	*[[ECG]]		*[[ECG]]
	*CT ~~Brain~~ non con and CTA head and neck		*[[CT brain]] non con and CTA head and neck
	*~~Chest Xray~~		*[[CXR]]
	*Basic Metabolic Panel		*Basic Metabolic Panel
	*CBC (to assess for severe anemia or thrombocytosis)		*CBC (to assess for severe anemia or thrombocytosis)
	*INR (if patient is ~~anticogulated~~)		*INR (if patient is anticoagulated)
	*MRI (if suspicion for [[CVA]], [[Multiple Sclerosis]], or undifferentiated mass lesion)		*MRI (if suspicion for [[CVA]], [[Multiple Sclerosis]], or undifferentiated mass lesion)
	*Ocular ultrasound (evaluate for retinal detachment or hemorrhage)		*[[Ocular ultrasound]] (evaluate for retinal detachment or hemorrhage)

	==Management==		==Management==
	''Management also varies also based final diagnosis''		''Management also varies also based final diagnosis''
	*Intrinsic ocular causes require ophtho evaluation and referral		*Intrinsic ocular causes require ophtho evaluation and referral
	*Cardiologic cause requires ~~medicine~~ admission and cardiology consultation		*Cardiologic cause requires admission and cardiology consultation
	*Neurologic causes require ~~medicine~~ admission and neurologic consultation		*Neurologic causes require admission and neurologic consultation
	*Hematologic causes or ~~vasculatisis~~ related causes will require ~~medicine evaluation and~~ sub specialist consultation		*Hematologic causes or vasculitis related causes will require sub specialist consultation

	==Disposition==		==Disposition==

Devin Smith: /* Hemodynamic */

2017-02-20T07:28:15Z

Hemodynamic

← Older revision		Revision as of 07:28, 20 February 2017
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	===Hemodynamic===		===Hemodynamic===
	*[[Carotid stenosis]]		*[[Carotid stenosis]]
	*Arteritis ([[Temporal arteritis]], Takayasu's arteritis)		*Arteritis ([[Temporal arteritis]], [[Takayasu arteritis]])
	*Hypoperfusion ([[CHF]], [[Hyperviscosity syndrome]], hyper coagulable state)<ref>Bacigalupi M et al. "Amaurosis Fugax-A Clinical Review". The Internet Journal of Allied Health Sciences and Practice. 2006 4 (2): 1–6.[http://ijahsp.nova.edu/articles/vol4num2/Bacigalupi.pdf Fulltext]</ref><ref>Mundall J, Quintero P, Von Kaulla KN, Harmon R, Austin J (March 1972). "Transient monocular blindness and increased platelet aggregability treated with aspirin. A case report". Neurology 22 (3): 280–5.</ref>		*Hypoperfusion ([[CHF]], [[Hyperviscosity syndrome]], hyper coagulable state)<ref>Bacigalupi M et al. "Amaurosis Fugax-A Clinical Review". The Internet Journal of Allied Health Sciences and Practice. 2006 4 (2): 1–6.[http://ijahsp.nova.edu/articles/vol4num2/Bacigalupi.pdf Fulltext]</ref><ref>Mundall J, Quintero P, Von Kaulla KN, Harmon R, Austin J (March 1972). "Transient monocular blindness and increased platelet aggregability treated with aspirin. A case report". Neurology 22 (3): 280–5.</ref>

Alvarez13 at 23:23, 21 November 2016

2016-11-21T23:23:24Z

← Older revision		Revision as of 23:23, 21 November 2016
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	==Management==		==Management==
	''~~management~~ also varies also based final diagnosis''		''Management also varies also based final diagnosis''
	*Intrinsic ocular causes require ophtho evaluation and referral		*Intrinsic ocular causes require ophtho evaluation and referral
	*Cardiologic cause requires medicine admission and cardiology consultation		*Cardiologic cause requires medicine admission and cardiology consultation
	*Neurologic causes require medicine admission and neurologic consultation		*Neurologic causes require medicine admission and neurologic consultation
	*Hematologic causes or vasculatisis related causes will require medicine evaluation and sub specialist consultation		*Hematologic causes or vasculatisis related causes will require medicine evaluation and sub specialist consultation

	==Disposition==		==Disposition==
	*Close follow-up or admission depending on the final determined cause		*Close follow-up or admission depending on the final determined cause

Alvarez13 at 23:22, 21 November 2016

2016-11-21T23:22:48Z

← Older revision		Revision as of 23:22, 21 November 2016
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	*Drug abuse-related intravascular emboli		*Drug abuse-related intravascular emboli
	===Hemodynamic===		===Hemodynamic===
	*Carotid stenosis		*[[Carotid stenosis]]
	*Arteritis ([[Temporal arteritis]], Takayasu's arteritis)		*Arteritis ([[Temporal arteritis]], Takayasu's arteritis)
	*Hypoperfusion ([[CHF]], [[Hyperviscosity syndrome]], hyper coagulable state)<ref>Bacigalupi M et al. "Amaurosis Fugax-A Clinical Review". The Internet Journal of Allied Health Sciences and Practice. 2006 4 (2): 1–6.[http://ijahsp.nova.edu/articles/vol4num2/Bacigalupi.pdf Fulltext]</ref><ref>Mundall J, Quintero P, Von Kaulla KN, Harmon R, Austin J (March 1972). "Transient monocular blindness and increased platelet aggregability treated with aspirin. A case report". Neurology 22 (3): 280–5.</ref>		*Hypoperfusion ([[CHF]], [[Hyperviscosity syndrome]], hyper coagulable state)<ref>Bacigalupi M et al. "Amaurosis Fugax-A Clinical Review". The Internet Journal of Allied Health Sciences and Practice. 2006 4 (2): 1–6.[http://ijahsp.nova.edu/articles/vol4num2/Bacigalupi.pdf Fulltext]</ref><ref>Mundall J, Quintero P, Von Kaulla KN, Harmon R, Austin J (March 1972). "Transient monocular blindness and increased platelet aggregability treated with aspirin. A case report". Neurology 22 (3): 280–5.</ref>

	===Ocular===		===Ocular===
	*Ischemic optic neuropathy		*Ischemic optic neuropathy

← Older revision		Revision as of 18:18, 26 September 2020
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	*Close follow-up or admission depending on the final determined cause		*Close follow-up or admission depending on the final determined cause
	==See Also==		==See Also==
	*[[Acute ~~Vision Loss~~ (~~Noninflamed~~)]]		*[[Acute vision loss (noninflamed)]]

	==External Links==		==External Links==

← Older revision		Revision as of 18:17, 26 September 2020
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	*Close follow-up or admission depending on the final determined cause		*Close follow-up or admission depending on the final determined cause
	==See Also==		==See Also==
	[[Acute Vision Loss (Noninflamed)]]		*[[Acute Vision Loss (Noninflamed)]]

	==External Links==		==External Links==