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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2436
Experience:  MS Ophthalmology with 13 years of surgical expereince
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I have twice in 4 weeks experienced split second vision

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I have twice in 4 weeks experienced split second vision blackout. What is this? Should I be worried?
Dr. A.S. Desai :

Hello, Welcome to Just Answer

Dr. A.S. Desai :

Are you available for chat now?

Customer:

Hello, yes I am

Dr. A.S. Desai :

Is there any history of hypertension or diabetes? Are you taking any medicines?

Customer:

no, i have no history of either of these and I am not taking any medicines

Dr. A.S. Desai :

Was the blackout related to posture- such as sitting upright suddenly or standing ?

Customer:

no, on both occasions I was lying down. It lasted only a split second and there was no pain

Dr. A.S. Desai :

Ok.

Dr. A.S. Desai :

Such a transient obscuration of vision lasting for few seconds can be seen in conditions in which the blood supply is a bit reduced briefly ( called as ischemia). It is more common in those with hypertension or diabetes.

Customer:

I have been under a fair amount of stress in the last 2 months with lots of upheavals

Dr. A.S. Desai :

Of course there can be other causes for this ischemia too and need to be evaluated( smoking, hypercholestrolemia, vasculitis or even idiopathic).

Dr. A.S. Desai :

Stress is a known triggering factors in many of these conditions but usually not causative.

Customer:

What do you advise that I do please? The first time it happened I ended up thinking I either dreamed it or imagined it - that was about 4 weeks ago, but then it happened again this morning.

Dr. A.S. Desai :

I don't think you need to be worried but nevertheless get the eyes examined in detail especially the dilated eye examination by an ophthalmologist. This will help to know if there are any signs suggestive of ischemia ( reduced blood supply) . Any kind of changes in the blood vessels in the eye also reflect similar changes in the body .

Customer:

Ok, thanks. I last had my eyes tested about a year ago and everything was fine then. If it turns out I have ischemia is this treatable? Will the instant blackouts become more frequent?

Dr. A.S. Desai :

The underlying cause for the reduced blood supply needs to be tackled if found. In your case since the vision is good( you have not had any residual visual defect) it shows that the blood vessels went in for a brief vasospasm ( constiction) only . If there are underlying systemic issues then the transient obscuration of vision may get repeated.

Customer:

what in your opinion would be possible underlying causes for reduced blood supply?

Dr. A.S. Desai :

Such reduced blood supply can be seen in retinal artery emboli ( tiny blocks in the blood flow through the retinal artery at the back of the eye), anterior ischemic optic neuropathy, systemic vasculitis, hypercholestrolemia etc.

Dr. A.S. Desai :

The list of conditions can get long and only cause more worry or apprehension. So I guess it would be better to get the eyes examined by an ophthalmologist to confirm that the back of the eyes are fine. It is important to get this test done so that the exact picture can be known. Further management would depend on the outcome of its report. I have not mentioned ocular migraine here because typically it causes such visual loss for more than just a few seconds but less than half an hour.

Customer:

Could this ultimately cause a stroke or a TIA as I thought they were caused by blocks in blood supply? Will I also have to visit my doctor? I don't smoke by the way (I kept meaning to tell you that)

Dr. A.S. Desai :

No , I don't think two episodes of TOV could predict a stroke. These are only considered as forewarners to a possible systemic or ocular vasospasm or vasoconstriction. A thorough evaluation will only help to reach to a conclusive diagnosis.

Customer:

Thank you for your advice - you have reassured me. I will book an appointment with an ophthalmologist. Last question---what does TOV stand for? Thank you again.

Dr. A.S. Desai :

TOV stands for transient obscuration of vision. Just used the abbreviation as it saves the time taken to type it.

Dr. A.S. Desai :

You are most welcome.

Customer:

Thank you. Goodbye

Dr. A.S. Desai :

Thank you and best wishes

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Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

Dr. A.S. Desai :

Goodbye

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