ABSTRACT
Visual loss complaints are commonly encountered by treating physicians, neurologist and ophthalmologists. More specifically a presentation of non-organic (psychogenic) blindness is less frequently seen but does exist and requires proper evaluation and specific skills for it to be properly managed. This case is of a 19 years old male who presented with acute monocular blindness post trauma whom he also had past psychiatric history. Post thorough assessment, no organic cause was identified, and a diagnosis of psychogenic blindness was made. Psychological therapy was beneficial in aiding return of his vision.
ABSTRACT
BACKGROUND: Retinal artery occlusion can lead to sudden visual loss without pain. The acute management of retinal artery occlusion remains unresolved. CASE REPORT: A 65-year-old male was hospitalized to an emergency room for visual loss on the left side within 6 hours of onset. Combined occlusion at retinal artery and ciliary artery was confirmed by an ophthalmologist and we assessed ophthalmic artery occlusion. However, MRA revealed no significant steno-occlusion of internal carotid artery. Transfemoral cerebral angiography was carried out immediately and showed a movable thrombus at the orifice of the ophthalmic artery. We decided on endovascular thrombectomy to prevent permanent visual loss. Finally, his visual acuity was improved after successful thrombectomy. CONCLUSIONS: Although MRA is intact, small thrombus right at the orifice of the ophthalmic artery can cause a sudden monocular visual loss due to occlusion of the retinal artery. In this setting, urgent endovascular thrombectomy can offer visual improvement.
Subject(s)
Aged , Humans , Male , Blindness , Carotid Artery, Internal , Cerebral Angiography , Ciliary Arteries , Emergency Service, Hospital , Ophthalmic Artery , Retinal Artery , Retinal Artery Occlusion , Thrombectomy , Thrombosis , Visual AcuityABSTRACT
Transient monocular blindness (TMB) may occur in patients with systemic lupus erythematosus (SLE). Several mechanisms have been suspected as the causes of such TMBs. A 32-year-old female patient with SLE presented recurrent monocular altitudinal visual field defects lasting for several minutes and occurring less than six times per day. Her anticardiolipin antibody level was persistently positive. All cerebrovascular imagings were normal. We report a case of recurrent TMBs in SLE with antiphospholipid antibody syndrome, which may have been induced by vasospasm.
Subject(s)
Adult , Female , Humans , Amaurosis Fugax , Antibodies, Anticardiolipin , Antibodies, Antiphospholipid , Antiphospholipid Syndrome , Lupus Erythematosus, Systemic , Visual FieldsABSTRACT
PURPOSE: There has been no epidemiological data on unilateral visual disabilities in Korea. This study was conducted to investigate the causes and current clinical manifestation of unilateral blindness in Korea based on the register. METHODS: This study was performed of all unilateral blindness registered as sixth degree visual disability from January to December 2000. Sex, the age at onset, and leading causes of blindness were evaluated. RESULTS: Of 145 patients with available clinical data, men were 114(78.6%). The peak incidence of onset of unilateral blindness were at less than 10 years of age(32 patients, 22.1%) and twenties(29 patients, 20.0%). It was found that the leading causes in order of frequency of incidence were trauma(81 patients, 55.9%), congenital anomaly(20 patients, 13.8%), retinal disease(17 patients, 11.7%), glaucoma(12 patients, 8.2%), and corneal disease(7 patients, 4.8%). The mechanism of trauma was penetrating trauma(38 patients, 46.9%), traffic accident(21 patients, 25.9%), and blunt contusion(11 patients, 13.6%). CONCLUSIONS: The unilateral blindness in Korea was much more frequently seen in subjects aged 10 years or less and twenties. The main cause was trauma developed during playing or working. Therefore, health education and safety strategies should be considered for the prevention of unilateral blindness.