The intersection of ophthalmology and neurology: Diagnosing acute strokes through visual symptoms

To document how acute cerebrovascular accidents (CVAs) present first to an ophthalmologist.

Retrospective, observational, unicentric hospital-based study. The electronic medical records of new patients who presented to the Neuro-ophthalmology department of a tertiary eye hospital in the month of August 2022 were reviewed. Those with symptoms suggestive of an acute stroke requiring urgent neuroimaging were chosen for further study.

Out of the 710 new patients, 31 had a known CVA and presented with field defects (4.3%). We recognized nine new patients, subsequently diagnosed to have a CVA, initially presenting with ocular symptoms such as homonymous hemianopia in seven cases and two others as transient obscuration of vision and internuclear ophthalmoplegia.

Posterior circulation strokes commonly present first to an ophthalmologist, the early recognition of which is of utmost importance.