Transient monocular vision loss

Abstract

Transient monocular vision loss (TMVL) is a common presenting symptom in both primary care and ophthalmology clinics. The differential diagnosis is broad, and a physician must properly triage patients with TMVL to ensure adequate workup and prompt treatment. On initial evaluation, important questions include confirming monocular vision loss, episode length, progression over time, inciting factors, pattern of visual loss, and associated symptoms such as headache, pain, or double vision. Given the inherent transient nature of the vision loss, the physical exam can be normal when the patient presents to the clinic, underscoring the importance of a detailed history of presenting symptoms and review of medical history. Timing and necessity of further ophthalmic testing, neuroimaging, and serological analyses are guided by the patient's presenting symptoms and examination, with emphasis placed on life-saving measures for those patients at risk for developing a stroke and/or permanent vision loss.