Amaurosis Fugax OMG!
Some 4 years ago I was awakened around 4:00am. I noticed what appeared to be an afterimage similar to what we see after a picture is taken by someone using a flash in my right eye. Not fully awake, I just closed my eyes and noticed it still being present and decided to get up and go to the bathroom. Upon flipping the light switch, I noticed what seemed to be a wedge shaped drop out in my lower field of vision. At first thought I might be having a retinal detachment. I knew at 4:00am the emergency room was the last place to go and decided to go downstairs and clean the pool to take my mind off things. Perhaps an hour later, I came inside. My wife had gotten up and asked me what I was doing. I replied that I thought I was having a retinal detachment and as we spoke, I noticed that the former visual field defect had returned to normal. Being an optometrist, I knew a detached retina does not spontaneously reattach and so I thought perhaps I had slept on my hand and increased the intraocular pressure decreasing blood perfusion to the eye. Seemed logical at the time. Nonetheless, I waited for a respectable hour and phoned one of my retinal specialist friends to discuss what it might be and should I get checked. He said that it was possible, but the timeline seemed long for it to return and asked me to come in. After an extensive examination he discovered a small plaque that had apparently blocked a branch artery at the bifurcation but then moved past and settled where we could see clearly fluorescein flowing through the artery. He told me to go see my physician immediately listing many different tests I would need done. I admit I was in denial, after all I was diligent in seeing my primary doctor faithfully and other then a rise in LDL and switch from Lipitor to Crestor, everything was fine. I assured my concerned retinal doctor that I had a thorough exam and my doctor listened for bruit in my carotids and found none. He just shook his head and said, look, you're flipping plaques and where's the next one going to go? That's when he got my attention. I left his office and called Dr. Charles Smith's office told the receptionist my story and I was scheduled for the next day. Over the next couple of weeks, I had so many tests: MRA of my chest, neck carotids, circle of Willis, ultrasound of the carotids, stress test, Holter monitor, blood tests and maybe more. At the end of it all, the only thing that was found was on the MRA of the carotids which showed less then 30% blockage in the right carotid artery. This lines up nicely with the eye which was involved with "the event". My LDL had come down to 70 after switching to Crestor which was much improved so it's still a bit of a puzzle as to how this happened. My thoughts were that stuff happens. I had gotten complacent about not exercising and putting on 20 pounds. It didn't seem like much, but I made some changes in that area. Dr. Smith took such great care of me during this very concerning time. He got me in immediately and ordered up all the tests which were required. He's very helpful with advice regarding making good decisions and lifestyle changes. I cannot think of any physician that was more caring, thorough, who listens and explains to his patients, better than Dr. Smith. He and his staff make every visit a positive one. He's the best!