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Three presentations of monocular vision loss
Melissa E Trego1, Jean Marie Pagani
1The Eye Institute, Pennsylvania College of Optometry, Philadelphia, Pennsylvania 19141, USA.
Optometry (St. Louis, Mo.)
|February 16, 2006
Summary
Carotid artery disease can cause vision loss in individuals over 50. Prompt diagnosis and treatment of carotid artery stenosis are crucial to prevent stroke and vision impairment.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Surgery
Background:
- Carotid artery disease affects 30% of individuals over 50.
- Risk factors include hypertension, smoking, hyperlipidemia, and diabetes.
- Monocular vision loss and transient ischemic attacks are potential symptoms.
Observation:
- Three geriatric patients presented with monocular vision loss.
- All patients had retinal arterial emboli detected during fundus examination.
- Carotid duplex imaging revealed significant internal carotid artery stenosis in all cases.
Findings:
- Carotid artery stenosis, ranging from 50% to 79%, was diagnosed in all three patients.
- Retinal arterial emboli indicate an increased risk of stroke and vascular mortality.
- The cases highlight the link between carotid artery disease and vision disturbances.
Implications:
- Consider carotid artery disease in the differential diagnosis for patients over 50 with monocular vision loss.
- Diagnostic tools include duplex ultrasound, MRA, and carotid angiography.
- Surgical interventions like carotid angioplasty and endarterectomy may be indicated.