Sudden Vision Loss
Sudden visual loss can occur in one eye or in both eyes at the same time. The vision loss may affect central vision or peripheral vision. It may be partial loss of vision, or complete.
If the vision loss occurs in one eye, it is usually due to lack of blood flow to the eye itself. This may be due to a nearby plaque in the carotid artery (the main artery in the neck supplying the brain and eye) migrating up to the eye, or from a blood clot originating from the heart, carotid artery or other vessel leading to the eye. Occasionally, inflammation of blood vessels can cause sudden loss of vision. The affected eye can have a lack of blood flow to the optic nerve, retina, or both.
Dr. Banik recommends urgent work up for sudden loss of vision, which includes a detailed eye exam, visual testing, and special imaging of the optic nerve and retina.
If a stroke of the optic nerve is found, then additional tests such as bloodwork is necessary.
If a stroke of the retina is found (central retinal artery occlusion), urgent work up includes MRI brain and MRA, EKG, echocardiogram, carotid Doppler, blood tests, and evaluation by neurology for other signs of stroke. If a retinal stroke is detected very early within the first few hours, certain emergency treatments may be able to reverse the visual loss.
Sudden visual loss involving both eyes simultaneously is due to a problem in the back of the brain which is responsible for processing vision. This most commonly affects older adults with risk factors who may have narrowing of blood vessels supplying the back of the brain or a clot blocking blood flow.
Other associated symptoms can include loss of balance and decreased visual field on one side of vision. The amount of visual loss in a brain stroke varies; some will only notice difficulty reading, which others may have more severe visual loss and not be able to navigate their environment.
The work up is the same as that for a stroke of the retina as described above, and includes MRI brain and MRA. If a stroke is detected very early within the first few hours, certain emergency treatments may be able to reverse the visual loss.
Treatment of stroke beyond a few hours involves management of risk factors such as hgh blood pressure, high cholesterol, and diabetes. Some patients may benefit from visual rehabilitation with low vision specialists to maximize the use of their remaining vision.
Image above: Normal view of orchid
Image above: Loss of top half of vision, obscuring view of orchid
Whether Rudrani Banik, MD is the first Neuro-Ophthalmologist you are visiting for treatment of sudden loss of vision, or the last one, she will make sure she does everything in her power to find an effective treatment to help you see and function better.