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  • 1.  has anyone seen a case similar to this?

    Posted 01-14-2026 16:48

    A 74 year old healthy man in usual state of health had an episode of complete bilateral visual loss lasting only 5-10 seconds, unassociated with other neurological symptoms.  A second event occurred within  a minute. No visual sequelae were noted right after. 

    Has anyone had similar cases that lasted such a short period of time- and what if any cause was ever found? Could the occipital lobes turn completely off and then fully recover just seconds later?

    Complete neuro -op exam is negative including visual fields.  An MRI/MRA has been ordered. 

    Thanks. 



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  • 2.  RE: has anyone seen a case similar to this?

    Posted 01-14-2026 17:15
    I have seen this with vertebral artery compression associated with head position and got a dynamic doppler of the vertebral and carotid, with different head positions.
    Also saw this with POTS. 

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  • 3.  RE: has anyone seen a case similar to this?

    Posted 01-14-2026 20:31
    Dr. Pomeranz,
    In 1985 I evaluated a 78 y.o. lady with isolated, stereotypic, & transient ~10 second episodes of immediate & instantaneous total binocular blindness. It always recovered totally & as quickly as going blind. Because she noted a brief rapid heart beat as soon as her vision returned, I admitted her to the coronary step down unit, captured the events, which were always triggered by a high grade 2nd degree heart block that always lasted 5.8 seconds. After Insertion of a pacemaker, she became asymptomatic. I followed her for 6 years with no recurrences of the blinding spells. I always wondered if she had a concomitant stenosis of the top of the basilar artery. No vertebral angioplasty was done. Hope this helps.

    Robert Saul, MD 
    Senior fellow NANOS


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  • 4.  RE: has anyone seen a case similar to this?

    Posted 01-14-2026 20:40
    Angiogram not "plasty" RFS

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    Dr. Pomeranz,In 1985 I evaluated a 78 y.o. lady with isolated, stereotypic, & transient ~10 second episodes of immediate & instantaneous total...

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    Re: has anyone seen a case similar to this?
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    Jan 14, 2026 8:31 PM
    Robert Saul
    Dr. Pomeranz,
    In 1985 I evaluated a 78 y.o. lady with isolated, stereotypic, & transient ~10 second episodes of immediate & instantaneous total binocular blindness. It always recovered totally & as quickly as going blind. Because she noted a brief rapid heart beat as soon as her vision returned, I admitted her to the coronary step down unit, captured the events, which were always triggered by a high grade 2nd degree heart block that always lasted 5.8 seconds. After Insertion of a pacemaker, she became asymptomatic. I followed her for 6 years with no recurrences of the blinding spells. I always wondered if she had a concomitant stenosis of the top of the basilar artery. No vertebral angioplasty was done. Hope this helps.

    Robert Saul, MD 
    Senior fellow NANOS


    Sent from Gmail Mobile
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    Original Message:
    Sent: 1/14/2026 8:31:00 PM
    From: Robert Saul
    Subject: RE: has anyone seen a case similar to this?

    Dr. Pomeranz,
    In 1985 I evaluated a 78 y.o. lady with isolated, stereotypic, & transient ~10 second episodes of immediate & instantaneous total binocular blindness. It always recovered totally & as quickly as going blind. Because she noted a brief rapid heart beat as soon as her vision returned, I admitted her to the coronary step down unit, captured the events, which were always triggered by a high grade 2nd degree heart block that always lasted 5.8 seconds. After Insertion of a pacemaker, she became asymptomatic. I followed her for 6 years with no recurrences of the blinding spells. I always wondered if she had a concomitant stenosis of the top of the basilar artery. No vertebral angioplasty was done. Hope this helps.

    Robert Saul, MD 
    Senior fellow NANOS


    Sent from Gmail Mobile




    Original Message:
    Sent: 1/14/2026 5:15:00 PM
    From: Eric Singman
    Subject: RE: has anyone seen a case similar to this?

    I have seen this with vertebral artery compression associated with head position and got a dynamic doppler of the vertebral and carotid, with different head positions.
    Also saw this with POTS. 

    Sent via the Samsung Galaxy S23 Ultra 5G, an AT&T 5G smartphone
    Get Outlook for Android




  • 5.  RE: has anyone seen a case similar to this?

    Posted 01-14-2026 21:09
    Transient visual loss
    Doubt is occipital
    Would get carotids and echo and
    Octa  retinal flow interesting
    Any other mri prior?
    Irene INR neuroopth
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  • 6.  RE: has anyone seen a case similar to this?

    Posted 01-14-2026 22:19

    PS my patient has monoocular transient visual loss.

    Deb




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  • 7.  RE: has anyone seen a case similar to this?

    Posted 01-14-2026 22:23

    Other than the complete vascular work up, maybe try verapamil.

    Deb




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  • 8.  RE: has anyone seen a case similar to this?

    Posted 01-14-2026 22:50
    I would consider ECG/30-day cardiac event monitor as well, especially if the non-invasive angiography of the posterior circulation is okay, particularly in someone in their 70s. I have had 2 similar patients (brief complete vision loss OU without any other accompanying neurologic or non-neurologic symptoms) in the past three years return for 6-week follow-up visits having already underwent pacemaker placement. I have also had several with a negative CTA/MR/cardio-embolic work-up who never had recurrence (but could consider loop recorder if they did).

    Parker Bohm



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  • 9.  RE: has anyone seen a case similar to this?

    Posted 01-19-2026 07:30

    I always make sure to do a complete cardiovascular work-up in these cases at these ages (as well as consider GCA), but the yield is not high.

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  • 10.  RE: has anyone seen a case similar to this?

    Posted 01-19-2026 15:35
    Many...I always work these patients up for a posterior circulation transient ischemic attack as it certainly represents insufficiency to the vertebrobasilar  circulation.


    Matt

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