TRANSIENT MONOCULAR BLINDNESS CAUSED BY VASOSPASM

SPORADIC transient monocular loss of vision (amaurosis fugax) lasting a few seconds to several minutes has fascinated and perplexed clinicians for years. In the mid-19th century, von Graefe1 and later Gowers2 proposed an embolic pathogenesis. Temporary vasospasm, however, was later invoked to account for this type of visual loss.3,4 In 1959, Fisher5 observed platelet–fibrin emboli passing through the retinal vasculature during an episode of monocular blindness. This report helped establish the platelet–fibrin theory as an explanation of many transient and fixed ischemic visual deficits. We describe two patients with vasospastic transient monocular blindness, as demonstrated by photography of the fundus. © 1991, Massachusetts Medical Society. All rights reserved.