Amaurosis fugax, also called transient visual loss, is a condition in which a person loses sight in one eye or, rarely, both eyes for a short time. The vision loss 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. In some cases, vision loss may last for several hours. This condition is typically caused by interruption of blood flow in the artery that supplies blood to the retina. The retina is the part of the eye that contains the nerves needed for sight.

This condition can be a warning sign that a stroke may happen, either in the eye or in the brain. 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:

  • A buildup of cholesterol and fats, or plaque, in the artery (atherosclerosis). If any plaque breaks off and gets into the bloodstream, it can travel to other blood vessels, such as the retinal artery.

  • Diseases of the heart valves.

  • Certain blood conditions, such as sickle cell anemia, leukemia, and blood clotting (coagulation) disorders.

  • Inflammation of the arteries (vasculitis).

  • A fast or irregular heartbeat, such as atrial fibrillation.

  • Family history of stroke.

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.

  • Conditions that can lead to diseases of the heart and blood vessels (cardiovascular diseases), such as:

    • High blood pressure (hypertension).

    • High cholesterol.

  • Drinking too much alcohol regularly.

  • Use of drugs, especially cocaine.

  • Age. The risk increases with age.

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, including dilating drops and looking at the back of your eyes.

  • Carotid ultrasound. This checks for plaque in the carotid arteries in your neck.

  • Magnetic resonance angiography (MRA). This checks the carotid artery and the branches that supply the brain. MRA looks for areas of blockage or disease.

You may also have other tests, including:

  • Blood tests.

  • Electrocardiogram (ECG) to check your heart rhythm.

  • 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. You may also get an emergency referral to a clinic or medical center that treats strokes.

Other treatments focus on reducing your risk of having a stroke in the future. These may include:

  • Medicines, such as medicines to manage high blood pressure, diabetes, or cholesterol, or to thin the blood.

  • Surgical procedures, such as:

    • Carotid endarterectomy to remove plaque from the carotid artery.

    • Carotid angioplasty and placement of a small, mesh tube (stenting) to open the blocked part of the artery.

  • Lifestyle changes, such as stopping tobacco use, changing your diet, and getting enough exercise.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • If you are taking blood thinners:

    • Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs, such as ibuprofen. These medicines increase your risk for dangerous bleeding.

    • Take your medicine exactly as told, at the same time every day.

    • Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.

    • Wear a medical alert bracelet or carry a card that lists what medicines you take.

Eating and drinking

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  • 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 help with high blood pressure, high cholesterol, diabetes, or obesity. These include:

    • A diet that is low in salt (sodium) to manage high blood pressure.

    • A high-fiber diet that is low in saturated fat, trans fat, and cholesterol to control cholesterol levels.

    • A low-carbohydrate, low-sugar diet to manage diabetes.

    • A reduced-calorie diet that is low in sodium, saturated fat, trans fat, and cholesterol to manage obesity.

Lifestyle

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  • Maintain a healthy weight.

  • Stay physically active. Try to get at least 30 minutes of activity on most or all days.

  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.

  • Do not misuse drugs.

General instructions

  • Do not drink alcohol if:

    • Your health care provider tells you not to drink.

    • You are pregnant, may be pregnant, or are planning to become pregnant.

  • If you drink alcohol:

    • Limit how much you use to:

      • 0–1 drink a day for women.

      • 0–2 drinks a day for men.

    • Be aware of how much alcohol is in your drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).

  • 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:

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  • You have chest pain or an irregular heartbeat.

  • You have any symptoms of a stroke. “BE FAST” is an easy way to remember the main warning signs of a stroke.

    • B – Balance. Signs are dizziness, sudden trouble walking, or loss of balance.

    • E – Eyes. Signs are trouble seeing or a sudden change in vision.

    • F – Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.

    • A – Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.

    • S – Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.

    • T – Time. Time to call emergency services. Write down what time symptoms started.

  • You have other signs of a stroke, such as:

    • 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 (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Amaurosis fugax is a condition in which you lose sight for a short time.

  • This condition can be a warning sign that a stroke may happen. 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.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.