Decoding Transient Visual Obscurations

Dr. Kimberly Gokoffski describes the differential diagnosis for transient visual obscurations. The diagnosis is stratified based on how long the symptoms have lasted and whether they are monocular or binocular. Events lasting a few seconds usually localize to the optic nerve head, and are associated with conditions such as papilledema or optic nerve head drusen. Events lasting 1 to 5 minutes, however, are usually vascular in origin and may stem from conditions such as amaurosis fugax or giant cell arteritis. In these cases, a coronary computed tomography angiogram of the head and neck, an echocardiogram or a 48-hour Holter monitor may be helpful in making the diagnosis. Finaly, events that last longer than 5 minutes are usually cortical in origin. 

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