Light-induced amaurosis associated with carotid occlusive disease

A 74-year-old man with the isolated complaint of uniocular transient visual loss after exposure to bright light was found to have severe ipsilateral, atherosclerotic carotid occlusive disease. Signs of ocular ischemia that were present included slightly reduced visual acuity, mild afferent pupillary defect, lowered intraocular pressure, increased photostress recovery time, and reduced opthalmodynamometry values on the affected side. After a subclavian to internal carotid artery bypass procedure, the patient's symptoms resolved completely and his ocular signs returned to normal. This patient's initial symptom, referred to as light-induced amaurosis (LIA), is an unfamiliar manifestation of the ocular ischemic syndrome. We discuss the condition and summarize the literature.