The neurologist will be quite familiar with common causes of transient or intermittent visual loss such as migraine, ischaemic amaurosis fugax and optic neuritis. However, if there is any doubt about the diagnosis, and the patient hasn’t already been seen by an ophthalmologist, then he or she should be referred to make sure the eye itself is normal. This is because confusion can occasionally arise when the visual loss is actually ocular in origin, as in the following examples.
OBSCURATIONS DUE TO PAPILLOEDEMA
Patients with papilloedema of any cause can develop transient visual disturbance, often brought on by change in posture such as bending over. The visual loss is typically ‘grey’ rather than ‘black’, bilateral rather than monocular, and lasts for a matter of seconds, as opposed to the total visual loss in ischaemic and monocular amaurosis fugax, which typically lasts a minute or two.
FUCHS’ CORNEAL ENDOTHELIAL DYSTROPHY (CORNEAL
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