The patient was heparinized, then started on Coumadin. By Christmas, she was home and out of danger. Careful history and examination of the patient who has experienced visual loss often can suggest the source of the problem, direct and streamline further evaluation, prevent indiscriminate testing, and determine the correct etiologic diagnosis and appropriate treatment efficiently and economically. Permanent visual loss can sometimes be preceded by transient visual loss. Embolism Embolism is a common cause of cerebral or retinal vascular obstruction leading to visual loss.
Patients often report episodes of transient visual loss or dimming before losing vision permanently.
It is important to consider that transient visual loss can result from pathology affecting one eye, or from pathology affecting one half of the visual field in both eyes. Patients unfamiliar with the anatomy of the visual system usually report the problem in one eye even when they have actually experienced an homonymous hemianopsia. With clues from history and careful physical examination, the ophthalmologist may be able to locate the defect nevertheless. Amaurosis fugax, from the Latin for fleeting blindness, is much less common than homonymous hemianopic loss. Monocular vision loss tends to be brief, lasting only seconds to minutes, whereas binocular homonymous hemianopsia may last for 20 to 30 minutes before resolving.