Amaurosis Fugax

What is amaurosis fugax?

Amaurosis fugax refers to a temporary and painless loss of vision in one (monocular) or both (binocular) eyes due to disruption of the blood flow to the retina. The retina is the layer of cells at the back of your eye that changes light into electrical signals for your brain to convert to images.

The phrase “amaurosis fugax” combines the Greek word for darkness (amaurosis) with the Latin word for brief (fugax). The loss of sight usually lasts seconds to minutes. It can be partial or complete.

You might hear other names for this condition, including transient monocular blindness, transient monocular visual loss or transient binocular visual loss.

Reasons behind the loss of vision vary from relatively harmless to more serious. Your eye care provider will work with you to identify the correct cause, which will then lead to the correct treatment.

Any sudden loss of vision is a medical emergency.

What are the symptoms of amaurosis fugax?

The symptoms of amaurosis fugax include shadowing or blurring of part of your vision, or a complete blackout of vision, that causes no pain. It may seem like a curtain is falling from the top of your eye down toward the bottom or that someone is drawing a curtain across your eye from one side toward the other.

Amaurosis fugax, as its name suggests, is temporary (fleeting). It goes away on its own.

It might happen more than once. It’s important to get medical help for any type of sudden vision loss, whether or not it’s painful.

What causes amaurosis fugax?

A blockage of blood flow to the retina causes amaurosis fugax. What’s important is to find out why the blockage has happened so your provider can suggest the correct treatment.

Potential causes of blockages of your retinal artery include:

• Blood clots.
• Plaque that breaks away from its original location (atherosclerosis).
• Inflammation of your optic nerve.

Your healthcare provider will want to examine you for the following conditions that may have amaurosis fugax as a symptom. These include:

• Transient ischemic attack (TIA).
• Stroke.
• Giant cell arteritis, also called temporal arteritis.
• Optic neuritis.
• Multiple sclerosis (MS).
• Traumatic brain injury (TBI).

What are the risk factors for amaurosis fugax?

Amaurosis fugax risk factors include modifiable and unmodifiable factors, including:

• Carotid artery stenosis.
• Hypertension (high blood pressure).
• Hypercholesterolemia.
• Smoking.
• Having had previous TIAs.
• Diabetes.
• Heart disease.
• Cocaine use.
• Alcohol use disorder.
• Being age 50 or older.

What are the complications of amaurosis fugax?

The complications that may be associated with amaurosis fugax can be severe: a stroke, a cardiac event and even death.

How is amaurosis fugax diagnosed?

Your healthcare provider will ask you about your medical history and your symptoms. They’ll do a complete eye exam. Your answers to questions about other conditions like high blood pressure and heart disease will be especially important.

What tests will be done to diagnose amaurosis fugax?

If your provider suspects you have amaurosis fugax, they may order a variety of tests, including many related to your vascular health. Tests may include:

• A physical examination.
• Blood tests, including a complete blood count (CBC), blood sugar testing and clotting times.
• Imaging tests of your vascular system, including ultrasounds, magnetic resonance imaging (MRI) scans and computed tomography (CT) scans.
• An electrocardiogram.
• Holter monitor testing.
• C-reactive protein testing.
• Sed rate test.

How is amaurosis fugax treated?

Treatment of amaurosis fugax depends on its cause. Many of the causes (like stroke) need immediate treatment. Other related illnesses, such as giant cell arteritis, will have their own types of treatment.

Can amaurosis fugax be prevented?

While you may not be able to prevent amaurosis fugax, you may be able to lower your risk of developing amaurosis fugax by managing your health.

How can I lower my risk?

You may be able to lower your risk of developing amaurosis fugax by:

• Managing chronic conditions like high blood pressure, diabetes, high cholesterol and others.
• Eating healthy foods, like those in the Mediterranean diet.
• Seeking and maintaining a weight that’s healthy for you.
• Staying physically active.
• Quitting smoking.
• Drinking alcohol in moderation.

What can I expect if I have this condition?

The outlook for amaurosis fugax can depend on what’s causing it. Getting immediate medical help is important, especially for conditions like stroke.

Amaurosis fugax is, by its nature, a temporary condition. However, the illnesses that cause it or that are associated with it are conditions that require treatment and/or management.

If you have conditions like giant cell arteritis or multiple sclerosis, you’ll need to follow your provider’s treatment recommendations for those things. Treating the associated illnesses will also treat the amaurosis fugax.

When should I see my healthcare provider about vision issues?

Always get immediate medical help if you have sudden vision loss, with or without pain.

Outside of emergencies, follow the eye examination schedule that your provider recommends.

What questions should I ask my healthcare provider about amaurosis fugax?

Hopefully, you’ll feel confident in asking your healthcare provider any questions you may have. You may want to ask:

• Is this episode of amaurosis fugax related to any other health condition?
• What would you consider a medical emergency for me?
• What type of treatment do you recommend?
• What are the potential side effects of that treatment?
• Do you recommend that I see a specialist for treatment?
• What type of examination schedule do you recommend?

A note from Cleveland Clinic

If you have a brief period of time when your vision is impaired — if you feel like a curtain has fallen over your vision — you might be experiencing amaurosis fugax. If that’s true, or if you ever have a sudden loss of vision, you should get immediate medical help. Then healthcare providers will work with you to find out what might be causing this amaurosis fugax or if you have another related condition.

Usually, the sooner you get a diagnosis, the sooner you can get treatment, and the better the outcome is likely to be. So don’t hesitate to get help with any sudden loss of vision, with or without pain. And don’t hesitate to ask your provider for help in dealing with the diagnosis and treatment.