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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 answers13 doctors weighed in
Dr. Ipe Kalathoor
Internal Medicine 18 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.
Dr. Creighton Wright
surgery 57 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
Sports Medicine 47 years experience
Read the book called Future Of Mankind related to food
Apr 22, 2013
Dr. Victor Bonuel
Internal Medicine 39 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.
Dr. Timothy Wu
Vascular Surgery 19 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.
Dr. William Gaya
Neurology 30 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
Dr. Timothy Wu commented
Vascular Surgery 19 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 Wright
surgery 57 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.
Last updated Mar 24, 2015

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