If you are able to read this sentence without problems, you should consider yourself lucky and you should not take this for granted. Many people underestimate their eye health as they think their eye will forever be okay. However, there are many diseases that can affect the eyes which can cause a person to have vision problems. Some vision problems may be fixed with glasses but some of them may not be able to be treated, causing a person to be blind. In this DoctorOnCall’s article, we will learn about amaurosis fugax, an eye disease that can cause blindness.
Amaurosis fugax refers to sudden transient vision loss that can occur in one or both eyes. This condition is caused by a blocked blood vessel. Specifically, it is the result of occlusion or stenosis of the internal carotid artery circulation. The occlusion or blockage is by thromboembolism. Thromboembolism is the substance made up of cholesterol plaques and often known as the blood clot. You can say that amaurosis fugax is similar to the ‘mini stroke’ you probably heard but it mainly affects the eye.
Amaurosis fugax typically occur in those aged 50 and above with risk factors such as hypertension (high blood pressure), hypercholesterolaemia (high cholesterol), previous episode of transient ischemic attack (TIAs), diabetes, atrial fibrillation, hypercoagulative state and smoking. Risk factors are factors that when a person has it, it increases the chances for the condition. Despite that amaurosis fugax is more common in adults, there are cases where children are affected but it is often benign.
Most patients with amaurosis fugax describe visual symptoms such as a “curtain passing across the eye” which eventually block eye vision. The severity of the visual area affected varies as some may be affected partially or entirely. The visual loss is painless. The sudden vision loss can last between 2 to 30 minutes. This episode typically resolves on its own. Some may experience multiple episodes. Amaurosis fugax rarely progressed to permanent loss of vision.
To diagnose amaurosis fugax, doctors will ask for the patient’s medical history. This includes any possible underlying condition that could precipitate to the risk factors. Physical examination, emphasising the eyes examination will be done. Eye examination will include a complete eye examination with pupil dilation and evaluation of the carotid arteries with the heart. Blood tests such as complete blood test, lipid level and glucose level are among the common tests done to check for the underlying cause. Imaging tests such as ultrasound are used to assess the arteries. MRI and CT scan can help evaluate the arteries flow.
How do you fix amaurosis fugax? To fix this issue, controlling and treating the underlying risk factors or disease is the first aim to focus on. Most patients only require conservative treatment such as medication to control the disease such as blood thinners and anti-cholesterol to prevent blood clots. Carotid stenting is commonly used as surgery to widen the narrow vessels. In rare cases, more invasive techniques such as carotid enterectomy which is removing the vessel blockage may be needed in severe cases. Steroids may be prescribed in case of suspected temporal arteritis which is in those aged 60 and above.
It is important for those with amaurosis fugax symptoms to get checked by a doctor. It is considered as an emergency condition that needs immediate medical care. Those who have had amaurosis fugax once are likely to have another episode of the temporary vision loss. The issue with this condition is that by having future episodes of amaurosis fugax, increase risk for permanent vision loss or stroke. Most untreated patients with significant carotid artery plaques will develop major stroke within 12 months. The most terrifying part of amaurosis fugax is not only the permanent vision loss, but also death that may follow. Thus, it is vital for patients that have had even one episode of amaurosis fugax to get checked by a doctor. This can help to treat the vision loss issues and also treat the underlying cause from causing further health issues.
It can be concluded that amaurosis fugax is the temporary vision loss that occurs suddenly. It is often painless. Even if it is considered as a temporary issue, it can increase the risk for a person to have permanent vision loss or stroke when it is left untreated. Amaurosis fugax is likely to affect older adults, especially those with risk factors. Diagnosis mainly is made based on the patient’s medical history and eye examination. Treatment for amaurosis fugax usually revolves around tackling the thromboembolism by medication or surgery. Tackling the underlying risk factors besides from blood thinners at the first hour is vital in preventing full-blown stroke. Carotid stenting is more favoured than carotid enterectomy due to the fact that it is less invasive. Invasive procedure is only indicated when necessary such as in severe cases. Patients need to take medication as instructed by healthcare professionals even after surgery so that the underlying condition could not cause more body damage.