A patient presents with episodic monocular visual loss lasting 5–10 minutes described as a 'curtain descending from above'. This classic presentation of amaurosis fugax is caused by:
- A Vasospasm of central retinal artery in migraine
- B Thromboembolism from ipsilateral carotid artery stenosis to the central retinal artery ✓
- C Intermittent angle-closure glaucoma compressing the optic nerve
- D Anterior ischemic optic neuropathy
Explanation
Amaurosis fugax ('fleeting blindness') is a TIA of the retina, classically caused by cholesterol emboli (Hollenhorst plaques) or platelet-fibrin emboli originating from ipsilateral carotid artery stenosis lodging transiently in the central retinal artery or its branches. The descending curtain description reflects superior retinal ischaemia as the embolus affects inferior branches first. Hollenhorst plaques (bright, refractile, cholesterol emboli at arteriolar bifurcations) may be seen on fundoscopy. Urgent carotid Doppler, echocardiography, and antiplatelet therapy/endarterectomy (if stenosis >70%) are indicated to prevent ipsilateral stroke.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.