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Transient visual disturbances
Last reviewed: 06.07.2025
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I. Transient blindness or decreased vision in one eye
Transient monocular blindness can be observed with cardiogenic embolism or due to the detachment of thrombus fragments in the bifurcation zone of the carotid artery (less often - from other arteries or with the abuse of certain medications).
Typically, these are short (3-5 minutes) episodes of quadrant, hemiplegic or total visual loss, accompanied by contralateral hemiplegia with (or without) hemihypesthesia (oculohemiplegic syndrome).
Hemodynamic disturbances in severe atheromatosis or other occlusive vascular diseases (Takayasu's disease), as well as in situations of hypoperfusion (heart failure, arrhythmia, acute hypovolemia, coagulopathy) are another possible cause of transient monocular blindness.
Vascular disorders in the orbit and optic nerve (anterior ischemic optic neuropathy; occlusion of the central retinal artery or its branch; occlusion of the central retinal vein).
Neurological causes of transient blindness are varied and cause transient visual impairment in both eyes simultaneously or sequentially due to swelling of the optic nerve papilla (processes in the brainstem and optic nerve, for example, multiple sclerosis), and less often other causes (tumor, migraine, psychogenic visual impairment).
Idiopathic variants of transient monocular blindness are possible, when a detailed examination does not reveal any possible causes for its occurrence.
Psychogenic transient monocular blindness.
II. Transient blindness or decreased vision in both eyes
- Migraine (vasospasm).
- Cerebral hypoperfusion (thromboembolism, systemic hypotension, increased blood viscosity).
- Epilepsy.
- Edema of the optic nerve papillae (transient decrease in vision).