TMVL that is specifically induced by moving the eyes toward a certain direction (gazeevoked TMVL) suggests an orbital mass such as hemangioma or meningioma. The TMVL likely results from a combination of direct compression of the optic nerve and ischemia from positional vascular obstruction. Careful examination usually reveals other orbital findings, such as proptosis or limited ocular motility.
Otto CS, Coppit GL, Mazzoli RA, et al. Gaze-evoked amaurosis: a report of five cases. Ophthalmology. 2003;110(2):322–326.
Excerpted from BCSC 2020-2021 series: Section 5 - Neuro-Ophthalmology. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.