Transient visual loss

TVL is a sudden onset, yet temporary, monocular or binocular loss of vision that is often caused by a temporary disruption of blood supply to the eye or visual pathways. It can also result from a wide variety of other causes, including neurologic conditions, such as migraine, and ophthalmic conditions, such as optic disc edema. As the possible causes are so varied and physical examination is often unremarkable, it is crucial to obtain an accurate account of the episode. The first and most important step is to determine if the visual loss was monocular or binocular, keeping in mind that transient homonymous visual field loss will often be mistaken for monocular visual loss. Diagnostic investigations should be tailored toward the suspected cause, taking into account the age of the patient and their comorbidities. As some causes of TVL, such as TIAs and GCA, are true medical emergencies, the clinician should have a low threshold for urgent evaluation of patients who may have these conditions.