Sudden loss of vision in a patient with significant ipsilateral internal carotid disease.
A 74-year-old man developed sudden onset of painless persistent partial loss of vision in the right eye 3 days after right total knee replacement. The initial investigation was for amaurosis fugax with a normal CT scan of the brain but the carotid Doppler confirmed >90% stenosis of the right internal carotid artery. Urgent ophthalmological review confirmed anterior ischaemic optic neuropathy. Subsequently, he lost his vision completely in the right eye. He had a previous high risk hemispheric transient ischaemic attack with carotid Doppler reported as normal.
Medicine for Older People, Basildon & Thurrock Hospitals NHS Foundation Trust, Basildon, UK. farhad.huwez@hotmail.com
Farhad
F
Huwez
Udayaraj
U
Umasankar
Edward
E
Casswell
Jay
J
Menon
Narasimha
N
Gadi
D000368:Aged; D020757:Amaurosis Fugax / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000150:complications*; D002343:Carotid Artery, Internal; D006801:Humans; D008297:Male