Monocular blindness

Due to a lesion anterior to the optic chiasm.

1. Amaurosis fugax: often described as a “shade coming down” over one eye

a) TIA: usually due to occlusion of the retinal artery

b) giant cell arteritis (GCA): usually due to ischemia of optic nerve or optic tracts (less commonly due to retinal artery occlusion) 1).

2. trauma: optic nerve injury

3. ruptured carotid cavernous aneurysm: resultant carotid-cavernous fistula increases intraocular pressure by impeding venous return

4. intraorbital pathology: tumors

5. injury within the globe: retinal detachment, ocular trauma

6. unilateral vitreous hemorrhage: e.g. with SAH (Terson’s syndrome)


1)
Salvarani C, Cantini F, Boiardi L, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med. 2002; 347:261–271
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