NANOSNET

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb

It appears it is bilaterally symmetric, and below may NOT be related, but ask a few more questions.

See if it is truly symmetric or if one eye is affected first and then the other.

And rather than being related to exercise, is it related to the brightness that occurs from being outdoors????

If history is related to brightness, you may be familiar with this article:

Light-induced Amaurosis: A Rare Manifestation of Internal Carotid Artery Stenosis

Ru Jin Eugene Ting 1,✉, Michelle Hui 2, Catherine Thoo 3, Minas T Coroneo 2, Ian C Francis 2

Editors: Alexander Muacevic, John R Adler

PMCID: PMC6823093  PMID: 31737459

Likely, he has had this w/u already for carotid artery disease, but if not, you may consider it.  Could he have bilateral carotid disease, and perhaps in the setting of his venous return (not sure if venous return from head is affected???), a congenital problem , perhaps less carotid artery obstruction could more easily provoke this unusual symptom.

Further, per the article, it is theorized in the setting of carotid stenosis and subsequent retinal hypoperfusion, the increase in retinal metabolism demanded by the exposure to light cannot be sustained, and this therefore manifests as light-induced amaurosis.

However, it disappears as the patient continues in the light, which is what is happening in this subject.

Jade

Jade S. Schiffman MD, FAAO, FAAN

Co-Director of Neuro-Eye Clinical Trials, Inc. 

Co-Director Neuro-ophthalmology of Texas, P.L.L.C.

Former Professor of Ophthalmology and Neurology, University of Texas MD Anderson Cancer Center

Adjunct Professor, Department of Clinical Sciences, UH College of Medicine

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb

It appears it is bilaterally symmetric, and below may NOT be related, but ask a few more questions.

See if it is truly symmetric or if one eye is affected first and then the other.

And rather than being related to exercise, is it related to the brightness that occurs from being outdoors????

If history is related to brightness, you may be familiar with this article:

Light-induced Amaurosis: A Rare Manifestation of Internal Carotid Artery Stenosis

Ru Jin Eugene Ting 1,✉, Michelle Hui 2, Catherine Thoo 3, Minas T Coroneo 2, Ian C Francis 2

Editors: Alexander Muacevic, John R Adler

PMCID: PMC6823093  PMID: 31737459

Likely, he has had this w/u already for carotid artery disease, but if not, you may consider it.  Could he have bilateral carotid disease, and perhaps in the setting of his venous return (not sure if venous return from head is affected???), a congenital problem , perhaps less carotid artery obstruction could more easily provoke this unusual symptom.

Further, per the article, it is theorized in the setting of carotid stenosis and subsequent retinal hypoperfusion, the increase in retinal metabolism demanded by the exposure to light cannot be sustained, and this therefore manifests as light-induced amaurosis.

However, it disappears as the patient continues in the light, which is what is happening in this subject.

Jade

Jade S. Schiffman MD, FAAO, FAAN

Co-Director of Neuro-Eye Clinical Trials, Inc. 

Co-Director Neuro-ophthalmology of Texas, P.L.L.C.

Former Professor of Ophthalmology and Neurology, University of Texas MD Anderson Cancer Center

Adjunct Professor, Department of Clinical Sciences, UH College of Medicine

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb

It appears it is bilaterally symmetric, and below may NOT be related, but ask a few more questions.

See if it is truly symmetric or if one eye is affected first and then the other.

And rather than being related to exercise, is it related to the brightness that occurs from being outdoors????

If history is related to brightness, you may be familiar with this article:

Light-induced Amaurosis: A Rare Manifestation of Internal Carotid Artery Stenosis

Ru Jin Eugene Ting 1,✉, Michelle Hui 2, Catherine Thoo 3, Minas T Coroneo 2, Ian C Francis 2

Editors: Alexander Muacevic, John R Adler

PMCID: PMC6823093  PMID: 31737459

Likely, he has had this w/u already for carotid artery disease, but if not, you may consider it.  Could he have bilateral carotid disease, and perhaps in the setting of his venous return (not sure if venous return from head is affected???), a congenital problem , perhaps less carotid artery obstruction could more easily provoke this unusual symptom.

Further, per the article, it is theorized in the setting of carotid stenosis and subsequent retinal hypoperfusion, the increase in retinal metabolism demanded by the exposure to light cannot be sustained, and this therefore manifests as light-induced amaurosis.

However, it disappears as the patient continues in the light, which is what is happening in this subject.

Jade

Jade S. Schiffman MD, FAAO, FAAN

Co-Director of Neuro-Eye Clinical Trials, Inc. 

Co-Director Neuro-ophthalmology of Texas, P.L.L.C.

Former Professor of Ophthalmology and Neurology, University of Texas MD Anderson Cancer Center

Adjunct Professor, Department of Clinical Sciences, UH College of Medicine

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb

It appears it is bilaterally symmetric, and below may NOT be related, but ask a few more questions.

See if it is truly symmetric or if one eye is affected first and then the other.

And rather than being related to exercise, is it related to the brightness that occurs from being outdoors????

If history is related to brightness, you may be familiar with this article:

Light-induced Amaurosis: A Rare Manifestation of Internal Carotid Artery Stenosis

Ru Jin Eugene Ting 1,✉, Michelle Hui 2, Catherine Thoo 3, Minas T Coroneo 2, Ian C Francis 2

Editors: Alexander Muacevic, John R Adler

PMCID: PMC6823093  PMID: 31737459

Likely, he has had this w/u already for carotid artery disease, but if not, you may consider it.  Could he have bilateral carotid disease, and perhaps in the setting of his venous return (not sure if venous return from head is affected???), a congenital problem , perhaps less carotid artery obstruction could more easily provoke this unusual symptom.

Further, per the article, it is theorized in the setting of carotid stenosis and subsequent retinal hypoperfusion, the increase in retinal metabolism demanded by the exposure to light cannot be sustained, and this therefore manifests as light-induced amaurosis.

However, it disappears as the patient continues in the light, which is what is happening in this subject.

Jade

Jade S. Schiffman MD, FAAO, FAAN

Co-Director of Neuro-Eye Clinical Trials, Inc. 

Co-Director Neuro-ophthalmology of Texas, P.L.L.C.

Former Professor of Ophthalmology and Neurology, University of Texas MD Anderson Cancer Center

Adjunct Professor, Department of Clinical Sciences, UH College of Medicine

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb

It appears it is bilaterally symmetric, and below may NOT be related, but ask a few more questions.

See if it is truly symmetric or if one eye is affected first and then the other.

And rather than being related to exercise, is it related to the brightness that occurs from being outdoors????

If history is related to brightness, you may be familiar with this article:

Light-induced Amaurosis: A Rare Manifestation of Internal Carotid Artery Stenosis

Ru Jin Eugene Ting 1,✉, Michelle Hui 2, Catherine Thoo 3, Minas T Coroneo 2, Ian C Francis 2

Editors: Alexander Muacevic, John R Adler

PMCID: PMC6823093  PMID: 31737459

Likely, he has had this w/u already for carotid artery disease, but if not, you may consider it.  Could he have bilateral carotid disease, and perhaps in the setting of his venous return (not sure if venous return from head is affected???), a congenital problem , perhaps less carotid artery obstruction could more easily provoke this unusual symptom.

Further, per the article, it is theorized in the setting of carotid stenosis and subsequent retinal hypoperfusion, the increase in retinal metabolism demanded by the exposure to light cannot be sustained, and this therefore manifests as light-induced amaurosis.

However, it disappears as the patient continues in the light, which is what is happening in this subject.

Jade

Jade S. Schiffman MD, FAAO, FAAN

Co-Director of Neuro-Eye Clinical Trials, Inc. 

Co-Director Neuro-ophthalmology of Texas, P.L.L.C.

Former Professor of Ophthalmology and Neurology, University of Texas MD Anderson Cancer Center

Adjunct Professor, Department of Clinical Sciences, UH College of Medicine

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb

It appears it is bilaterally symmetric, and below may NOT be related, but ask a few more questions.

See if it is truly symmetric or if one eye is affected first and then the other.

And rather than being related to exercise, is it related to the brightness that occurs from being outdoors????

If history is related to brightness, you may be familiar with this article:

Light-induced Amaurosis: A Rare Manifestation of Internal Carotid Artery Stenosis

Ru Jin Eugene Ting 1,✉, Michelle Hui 2, Catherine Thoo 3, Minas T Coroneo 2, Ian C Francis 2

Editors: Alexander Muacevic, John R Adler

PMCID: PMC6823093  PMID: 31737459

Likely, he has had this w/u already for carotid artery disease, but if not, you may consider it.  Could he have bilateral carotid disease, and perhaps in the setting of his venous return (not sure if venous return from head is affected???), a congenital problem , perhaps less carotid artery obstruction could more easily provoke this unusual symptom.

Further, per the article, it is theorized in the setting of carotid stenosis and subsequent retinal hypoperfusion, the increase in retinal metabolism demanded by the exposure to light cannot be sustained, and this therefore manifests as light-induced amaurosis.

However, it disappears as the patient continues in the light, which is what is happening in this subject.

Jade

Jade S. Schiffman MD, FAAO, FAAN

Co-Director of Neuro-Eye Clinical Trials, Inc. 

Co-Director Neuro-ophthalmology of Texas, P.L.L.C.

Former Professor of Ophthalmology and Neurology, University of Texas MD Anderson Cancer Center

Adjunct Professor, Department of Clinical Sciences, UH College of Medicine

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb

It appears it is bilaterally symmetric, and below may NOT be related, but ask a few more questions.

See if it is truly symmetric or if one eye is affected first and then the other.

And rather than being related to exercise, is it related to the brightness that occurs from being outdoors????

If history is related to brightness, you may be familiar with this article:

Light-induced Amaurosis: A Rare Manifestation of Internal Carotid Artery Stenosis

Ru Jin Eugene Ting 1,✉, Michelle Hui 2, Catherine Thoo 3, Minas T Coroneo 2, Ian C Francis 2

Editors: Alexander Muacevic, John R Adler

PMCID: PMC6823093  PMID: 31737459

Likely, he has had this w/u already for carotid artery disease, but if not, you may consider it.  Could he have bilateral carotid disease, and perhaps in the setting of his venous return (not sure if venous return from head is affected???), a congenital problem , perhaps less carotid artery obstruction could more easily provoke this unusual symptom.

Further, per the article, it is theorized in the setting of carotid stenosis and subsequent retinal hypoperfusion, the increase in retinal metabolism demanded by the exposure to light cannot be sustained, and this therefore manifests as light-induced amaurosis.

However, it disappears as the patient continues in the light, which is what is happening in this subject.

Jade

Jade S. Schiffman MD, FAAO, FAAN

Co-Director of Neuro-Eye Clinical Trials, Inc. 

Co-Director Neuro-ophthalmology of Texas, P.L.L.C.

Former Professor of Ophthalmology and Neurology, University of Texas MD Anderson Cancer Center

Adjunct Professor, Department of Clinical Sciences, UH College of Medicine

How is his heart? If it was his chest, arm, neck or head hurting, it would sound like an angina equivalent.

Deb