![]() Visual aura associated with migraine is the most common cause of transient binocular visual loss (▶Fig. The most important step in evaluating a patient with transient visual loss is to establish whether or not the visual loss is monocular (lesions of the eye or anterior visual pathways) or binocular (lesions of the chiasm or retrochiasmal visual pathways). This chapter complements the overview of visual loss given in Chapter 5 and provides differential diagnoses and suggested management for transient monocular and binocular visual loss. The best clues to the fact that transient visual loss was actually binocular are reading impairment (monocular visual loss does not impair reading unless the unaffected eye had prior vision impairment)and visual loss confined to a lateral hemifield, that is, to the right or left of midline with respect to the vertical meridian (monocular visual loss does not usually cause that pattern of visual loss). They will usually localize it to the eye that lost its temporal field. Very few patients realize that binocular hemifield (homonymous) visual field loss affects the fields of both eyes. It is sometimes difficult to decide whether an episode of transient visual loss occurred in one eye (monocular) or both (binocular). The information below is from Neuro-ophthalmology Illustrated-2nd Edition. There may be associated headache, especially over the brow contralateral to the visual field loss, but the pain is usually coincident with the visual loss, rather than following the visual loss as in migraine. Vertebrobasilar ischemia may have associated symptoms: vertigo, dizziness, imbalance, diplopia, bilateral extremity weakness.Ħ. Complete binocular visual loss may represent a TIA in the distribution of the basilar artery.ĥ. Occipital TIAs are typically sudden in onset and last only a few minutes.Ĥ. Unilateral occipital TIA from the posterior cerebral artery manifests as a transient homonymous hemianopia.ģ. They are binocular and they may be localized to a hemifield or diffuse within the entire field of vision.Ģ. ![]() ![]() The patient typically complains of recurrent, brief, simple, positive visual phenomena, such as flashes of light or bubbles. Temporary partial or complete loss of sight in one or both eyes that is caused by an abrupt reduction in blood flow (ischemia) to an eye.ĭetermine whether the transient vision loss is unilateral or bilateral.Ī unilateral transient loss of vision localizes the lesion to the optic nerve or the eye. What are the characteristics of an occipital transient ischemic attack? Are occipital seizures more common in children or adults?ĩ. What are the characteristics of an occipital seizure?Ĩ. What 3 items are included in the differential diagnosis of transient binocular visual loss?ħ. Why is it important to determine whether transient vision loss is unilateral or bilateral?Ħ. What is the first step in evaluating transient vision loss?ĥ. What is the most common cause of transient monocular vision loss?Ĥ. What is the preferred term for abrupt and temporary vision loss in one eye?Ģ.
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