Transient Vision Loss

Summary: ● Transient vision loss (TVL) is also known as: ○ Transient monocular blindness (TMB) ○ Amaurosis fugax (AF) ● The problem that arises with transience: ○ Ophthalmologist exam is usually normal (unless there is a residual) -> the exam becomes unhelpful -> can only rely on the history ● The structure subsequently used: ○ ABCD​2​ score (0-7 points): A = Age (1 point) ● The older the patient, the more likely chance of stroke risk factor and problems with ischemia B = Blood pressure (1 point) ● Important to also know how much and how well controlled C = Clinical/chief complaint (1 or 2 points) ● ABCD​2​ should be applied to transient vision loss with the ‘C' being transient monocular blindness (not being hemiparesis or aphasia) D​2​ = Duration (1 or 2 points) and Diabetes (1 point) ● Minutes, especially more than 60 minutes presents worries regarding ischemia ○ Using ABCD​2​ scores to assess stroke risk: 0-3 = Can decide whether to handle as outpatient or not; stroke service still suggested >4 = Moderate stroke risk within the next two days; call stroke service 6-7 = Emergency room and stroke service. Highest risk is from first two days to 90 day