Transient Monocular Blindness Successfully Treated by Lowering Intraocular Pressure

Abstract

We describe an elderly gentleman with a ten-year history of transient monocular blindness of the right eye. Ten years previously he had suffered a stroke affecting his left side, carotid duplex showed total occlusion of the right internal carotid artery. It was postulated that his symptoms were due to hypoperfusion of the optic nerve head (ONH). His antihypertensive medication was stopped and his ocular symptoms improved, however his blood pressure became dangerously high. Consequently he was started on latanoprost eye drops to reduce his intraocular pressure and improve ONH perfusion. This led to a dramatic improvement in his symptoms, which worsened again when he ran out of drops. To our knowledge management of transient visual loss due to reduced ocular perfusion by lowering of intraocular pressure has not been described previously.

KEYWORDS:

• KEYWORDS Transient monocular blindness
• amaurosis fugax
• ocular perfusion
• Intraocular pressure
• internal carotid artery occlusion