Gaze-evoked blindness

Three patients with orbital lesions had substantial visual loss while maintaining their eye in an eccentric position of gaze (gaze-evoked blindness). The acuity rapidly returned to baseline levels on return to primary position. Two patients had optic nerve sheath meningiomas and one a displaced portion of orbital bone in contact with the globe. Disc abnormalities and/or choroidal folds were present in all three cases. Gaze-evoked blindness is characterized by the presence of an intraconal mass lesion, but proptosis may be subtle or not present at all. Gaze-evoked blindness should be considered in the differential diagnosis of all patients with atypical amaurosis fugax.