How is transient vision loss (TVL) treated?

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

The treatment of transient vision loss (TVL) depends on the cause. Some treatments for migraines, such as triptans, ergots, and beta-blockers, are avoided in migraine-induced transient vision loss owing to concern of worsening vasoconstriction. [34]

If an ischemic event is suspected, then the patient should be referred to a physician for investigation of any cardiovascular and cerebrovascular risk factors. A retrospective study from Japan showed 2.9% of patients admitted for TIA presented with transient vision loss. [40] Some of these patients benefit from antithrombotic therapy or carotid surgery. If the transient vision loss is monocular, the carotid system should be investigated, usually via carotid Doppler ultrasonography.

Other investigations may include echocardiography, a complete blood count (to rule out anemia), and inflammatory markers when giant cell arteritis is suspected. Neuroimaging is important for ruling out intracranial pathology affecting the visual pathway, particularly in patients with binocular disturbance. Empiric antiplatelet therapy (eg, daily aspirin) may be indicated while the evaluation is in progress for transient vision loss in patients with vasculopathy.

In cases where the diagnosis is uncertain, adequate follow-up care is important. Children with unexplained transient visual disturbances should be closely monitored.


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