This patient had a small asymptomatic embolus. Elective carotid workup revealed a 95% ipsilateral carotid stenosis that was subsequently treated with carotid endarterectomy.
Learning Points:
Acute retinal ischemia, defined as transient monocular vision loss (or amaurosis fugax), acute branch retinal artery occlusion, or acute central retinal artery occlusion, requires an immediate referral to the nearest stroke center.
Asymptomatic emboli, as in this patient, can be more effectively evaluated for an embolic source, which should include carotid doppler and cardiac B-scan ultrasonography.
