Retinal Detachment
Central retinal vein occlusion
Central retinal artery occlusion
Sudden loss is a frightening symptom for patients. It may represent an ongoing issue or only be temporary. The term transient monocular visual loss (TMVL) describes a sudden, transient loss of vision that lasts less than 24 hours.
The most common causes of a sudden painless loss of vision are as follows:
- ischaemic/vascular (e.g. thrombosis, embolism, temporal arteritis etc). This includes recognised syndromes e.g. occlusion of central retinal vein and occlusion of central retinal artery
- vitreous haemorrhage
- retinal detachment
- retinal migraine
Ischaemic/vascular
- often referred to as 'amaurosis fugax'
- wide differential including large artery disease (atherothrombosis, embolus, dissection), small artery occlusive disease (anterior ischemic optic neuropathy, vasculitis e.g. temporal arteritis), venous disease and hypoperfusion
- may represent a form of transient ischaemic attack (TIA). It should therefore be treated in a similar fashion, with aspirin 300mg being given
- altitudinal field defects are often seen: 'curtain coming down'
- ischaemic optic neuropathy is due to occlusion of the short posterior ciliary arteries, causing damage to the optic nerve
- incidence increases with age, more common than arterial occlusion