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In many cases, only one eye is affected and the person may not be aware of the loss of color vision until the examiner asks them to cover the healthy eye. People may also engage in "eccentric viewing" using peripheral vision to compensate for central vision loss characteristic in genetic, toxic, or nutritional optic neuropathy.
However, if the eyes are asymmetrically affected, i.e. one eye's optic nerve is more damaged than the other, it will produce an important sign called an afferent pupillary defect. [citation needed] Defective light perception in one eye causes an asymmetrical pupillary constriction reflex called the afferent pupillary defect (APD). [citation needed]
To minimize the risk of further visual loss in the fellow eye or the same eye, it is essential to reduce the risk factors. Common sense dictates trying to control the cardiovascular risk factors for many reasons, including protection from this happening to the second eye. Sudden vision loss should lead to an ophthalmological consultation.
Damage to the blood vessels supplying the optic nerves leads to insufficient blood supply to the nerve and subsequent optic nerve fiber death. Most cases of AAION result in nearly complete vision loss first to one eye. If the temporal arteritis is left untreated, the affected eye will likely suffer vision loss as well within 1–2 weeks.
One hypothesis suggests that the underlying cause may be a subtle decrease in blood flow to the optic nerve, which is enough to cause swelling of the nerve fibers but not severe enough to disrupt vision through tissue death and permanent damage to the optic nerve.
Central retinal artery occlusion: CRAO is characterized by painless, acute vision loss in one eye. [11] Central retinal vein occlusion: CRVO causes sudden, painless vision loss that can be mild to severe. [12] Branch retinal vein occlusion: sudden painless vision loss or visual field defect are the main symptom of BRVO. [13]
Major symptoms are sudden loss of vision (partial or complete), sudden blurred or "foggy" vision, and; pain on movement of the affected eye. [4] [5] [2]Many patients with optic neuritis may lose some of their color vision in the affected eye (especially red), with colors appearing subtly washed out compared to the other eye.
Obscured vision due to papilledema may last only seconds, while a severely atherosclerotic carotid artery may be associated with a duration of one to ten minutes. [6] Certainly, additional symptoms may be present with the amaurosis fugax, and those findings will depend on the cause of the transient monocular vision loss.
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