DEAR DR. GOTT: I am a 65-year-old female that is relatively healthy. I take atenolol for pre-hypertension and tapazole for hyperthyroidism, along with the recommended supplements calcium, vitamin D, fish oil, and fiber. I eat healthfully and am still working actively as a teacher. I am 5’8” and 140 pounds.
Two months ago I lost an arc of peripheral vision in my left eye only. My husband is an optometrist so I was quickly seen by him, a retinal specialist and a glaucoma specialist. The results showed the interior of my eye is normal; I have no retinal problems, no glaucoma and the nerve is healthy. I had an MRI which was normal. My dilemma is this: Do I pursue it further by going to one of the eye institutes here on the West coast or just let it be and see what happens? I would appreciate your thoughts on this.
Thank you for dispensing such sensible and educational advice.
DEAR READER: Sudden vision loss is uncommon and can be temporary or permanent depending on the cause.
Before I get further into potential causes, I must point out that, it is vital for people to see an eye specialist/ophthalmologist immediately, should they experience sudden loss of vision. If they can’t be seen within a reasonable amount of time, they should go to the emergency room of their local hospital, since some causes can be serious and have lasting effects if not caught quickly.
The most common cause of sudden vision loss is ischemia, a sudden reduction of oxygen and nutrients to tissue. Essentially, the cause is a stroke of the eye instead of the brain. It can cause temporary or permanent damage to the retina. In some cases it can be linked with high blood pressure, especially for those with poor or no control, peripheral vascular disease and coronary artery disease.
Amaurosis fugax literally means fleeting vision and can last from a few seconds to several minutes. It is considered a strong indicator of an increased risk of stroke (of the brain) and most commonly affects those 50 and older.
Ocular migraines can cause transient (comes and goes) vision loss that may last between 10 and 50 minutes and may or may not be followed by headache.
Giant cell arteritis, which I have previously written about (you can read it here: put in link) is an autoimmune disorders that typically affects older individuals. Associated visual loss is similar to that of amaurosis fugax but develops more gradually. Vision loss may be permanent and irreversible.
Rarely, tumors of the eye can cause vision loss; however, that loss is generally gradual.
And, finally, sudden vision loss has been linked with several impotence drugs and is usually temporary.
Because you received prompt treatment and were seen by three separate eye health specialists, none of whom could find a cause, I believe that you are likely in the clear. However, if you want to pursue the matter further, there is no harm in doing so. If your vision has returned (as occurs most often), it will be more difficult to determine the cause than if you were to have an ongoing loss. You can also discuss your concerns with your husband since he was directly involved in your care or one or both of the other physicians involved for their input. Perhaps a consult with a vascular specialist is in order to determine if there is an underlying cause.
