Intermittent loss of vision can be caused by amaurosis fugax. This is where blood supply to part of the retina is interrupted briefly. This occurs in patients with vascular risk factors e.g. hypertension, hypercholesterolaemia, peripheral vascular disease, coronary heart disease and stroke. A typical story is one of a dark curtain across the vision which lasts seconds to minutes and completely resolves. Patients should be referred to the neurovascular service with an assessment completed of their vascular risk factors.
Another cause of intermittent loss/disturbance of vision is migraine. This can cause tunnel vision (loss of peripheral fields) or disturbances of vision such as zigzags, TV static and shapes across the vision. It can occur with or without a headache and completely resolves within 24 hours.
Who to refer:
Please see Lothian GP and optometry ophthalmology referral pathway.
Urgency of the condition for details on how soon patients should receive an appointment.
Patients who present with a problem with their only seeing eye should be advised to see an optician/ophthalmologist for review.
Who not to refer:
Amaurosis fugax – please refer to the neurovascular clinic. Please assess vascular risk factors including blood pressure, cholesterol and diabetes.
How to refer:
We require a referral letter for EVERY patient.
The preferred referral process is via SCI Gateway. If sending/forwarding a referral via SCI gateway please include past medical history, allergies and medications
If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.
Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.
If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.
