Amaurosis fugax secondary to presumed cavernous hemangioma of the orbit

A 27-year-old woman had a two-year history of proptosis of the right eye associated with recent onset of transient visual loss in that eye on down-gaze only. Ultrasonography and computerized tomography revealed a presumed intraconal cavernous hemangioma of the right orbit. Direct pressure on the optic nerve, with subsequent vascular compromise to the nerve and retina, was felt to be the cause of the transient visual loss. While probably not common as a cause of amaurosis fugax, orbital tumor should be considered in the differential diagnosis of gaze-evoked, transient, monocular visual loss.