UT
A 53-year-old member asked about a 69-year-old male:
My husband was diagnosed with amaurosis fugax. opthlmic tests show no optic nerve damage. carotid ultrsound and echocardiogram both neg. what next?
4 doctor answers • 13 doctors weighed in

Dr. Ipe Kalathooranswered
Internal Medicine 19 years experience
Amayrosis fugax: Amaurosis fugax is transient loss of vision in one eye from circulatory issues. One of the causes is a clot from neck arteries or heart going into the eye through blood stream. There are other causes to be considered like glaucoma , vasculitis(inflammation of blood vessels especially giant cell arteritis) coagulation disorder. If all work up is negative , chance of recurrence is very low.
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Dr. Creighton Wright commented
surgery 58 years experience
Anti platelet medication is frequently recommended to reduce small platelet emboli from rough spots in the arterial circulation to the eye and brain
Apr 21, 2013

Dr. John Kayvanfar commented
Sports Medicine 48 years experience
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Apr 22, 2013

Dr. Victor Bonuelanswered
Internal Medicine 40 years experience
Sometimes it's hard : To find the exact cause. Vascular spasm may cause it but hard to prove. Some autoimmune condition may cause it.
Created for people with ongoing healthcare needs but benefits everyone.
5.2k viewsReviewed >2 years ago

Dr. Timothy Wuanswered
Vascular Surgery 20 years experience
Further imaging: If your husband is truly having amaurosis fugax and if the carotid ultrasound and heart echo are normal, then he needs a ct angiogram of the head, neck, and aortic arch to rule out other potential etiologies, including confirming the carotid arteries are disease free. Carotid ultrasound is a good, but not perfect, test. I'd suggest he see a board certified vascular surgeon to discuss further.
Created for people with ongoing healthcare needs but benefits everyone.
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Dr. William Gaya commented
Neurology 31 years experience
A trams esophageal echocardiogram may be more informative as it may provide better images of the left atrium and appendage., and aortic arch
May 7, 2013

Dr. Timothy Wu commented
Vascular Surgery 20 years experience
Provided original answer
Agreed. TEEs are more useful than TTEs in this setting in certain cases. Still a CTA best for evaluating calcification of the arch.
May 7, 2013

Dr. Creighton Wrightanswered
surgery 58 years experience
Migraine.: If associated with aura, headache and re urgency, this may be a migraine type.
Atherosclerosis with irregular plaque in the ascending aorta, as well as carotid plaque can cause embolism, or platelet emboli.
Anti platelet therapy may be helpful until or after the source is determined.
Some coagulopathies may also cause symptoms.
Created for people with ongoing healthcare needs but benefits everyone.
5.1k viewsReviewed >2 years ago
Last updated Mar 24, 2015
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