What is the role of echocardiography and electrophysiology in the workup of transient vision loss (TVL)?

Updated: May 21, 2019
  • Author: Andrew J Tatham, MD, MBA, FRCOphth, FEBO, FRCS(Ed); Chief Editor: Andrew G Lee, MD  more...
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Answer

Answer

Consideration should be given to echocardiography, depending on the history and systemic examination findings.

When visual loss is medically unexplained, it is important to address the possibility that a subtle pathologic condition may be present that was missed on an initial examination. Accordingly, electrophysiology should be considered to exclude abnormalities such as Batten disease or Stargardt disease.

Transient monocular visual loss in adults is usually caused by an atheromatous plaque in the carotid bifurcation that creates a temporary reduction in retinal blood flow. [38] Therefore, in adults with transient monocular visual loss, it is essential to evaluate the carotid circulation, as early carotid surgery intervention can be effective in the prevention of stroke. [39] In contrast, no cases of transient vision loss due to atheromatous carotid disease have been reported in children.


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