Unexplained visual loss is one of the most common reasons for neuro-ophthalmic consultation. Patients frequently mistake homonymous visual loss as a deficit confined to the eye that is ipsilateral to the field loss. If the visual loss is monocular, ascertain if there was horizontal respect to the visual loss. If the visual loss is bilateral, exclude a homonymous or heteronymous defect. Document if the perceived vision loss is at distance fixation, near, or both.
Patients often present to the neuro-ophthalmologist's office with complaints of presbyopia.
Degree of recovery Time until recovery after visual loss Transient visual obscurations that last for seconds may be due to increased intracranial pressure. Dry eyes also can cause transient visual phenomena. Gaze-evoked amaurosis may be due to optic nerve sheath meningioma or other orbital apex tumor. Transient visual loss with scintillations, fortification spectra, and movement that lasts 20-30 minutes then completely resolves suggests migraine. Sudden-onset visual loss with little recovery suggests an ischemic event.