Which Medical Specialty Should You Consult for Sudden Vision Loss?

Which specialty should I see?

A couple of years ago, I experienced several episodes where my vision suddenly went completely dark for a few seconds.
During that time, I had difficulty maintaining my balance, and my limbs would tremble.
I was conscious but unable to control my body; in mild cases, I could manage to squat down immediately, but in one severe instance, I collapsed.
I went to the hospital for an examination, including an EEG, but the doctors could not determine the cause.
After two to three years without any incidents, I recently experienced one or two episodes again.
I would like to know which specialty clinic I should consult.

ST, 20~29 year old female. Ask Date: 2017/02/03

Dr. Chen Taicheng reply Family Medicine

● When you suddenly experience a blackout, what were you doing? For example, prolonged standing or sitting, dehydration can lead to poor blood circulation, resulting in low blood pressure and symptoms similar to fainting (such as seeing black, inability to stand, etc.); if you change positions too quickly, such as standing up suddenly from lying down or sitting, this can also cause orthostatic hypotension, which presents similarly.
● Anemia (common in women due to menstrual blood loss, which can lead to low blood pressure), bradycardia, arrhythmias, hypoglycemia, emotional stress, overheating, and overcrowding can also cause similar symptoms.
Less common causes include pulmonary diseases, minor strokes, carotid artery sclerosis, or epilepsy.
● Considering your age, the likelihood of low blood pressure or anemia is higher.
It is recommended to consult a family medicine or neurology specialist for further examination and advice.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department is concerned about you~

Reply Date: 2017/02/03

More Info

If you are experiencing sudden vision loss accompanied by symptoms such as temporary blindness, difficulty maintaining balance, and trembling limbs, it is crucial to seek medical attention promptly. Given the complexity of your symptoms, the appropriate medical specialty to consult would be neurology. Neurologists specialize in disorders of the nervous system, which includes the brain, spinal cord, and peripheral nerves. Your symptoms could be indicative of a neurological issue, such as a transient ischemic attack (TIA), migraine with aura, or even a seizure disorder.

Sudden vision loss can occur for various reasons, and it is essential to differentiate between ocular causes (related to the eye itself) and neurological causes. In your case, the combination of visual disturbances and loss of motor control suggests that the underlying issue may not be solely ocular. Neurological evaluations often include imaging studies like MRI or CT scans, as well as electroencephalograms (EEGs) to assess brain activity.

In addition to consulting a neurologist, it may also be beneficial to see an ophthalmologist. An eye specialist can conduct a thorough examination of your eyes to rule out any ocular conditions that could contribute to your symptoms, such as retinal detachment, vitreous hemorrhage, or other retinal disorders. They can also assess for conditions like glaucoma or macular degeneration, which can lead to vision loss.

Your history of episodes lasting a few seconds, during which you experienced temporary blindness and loss of balance, raises concerns about potential vascular issues affecting the brain. TIAs, often referred to as "mini-strokes," can present with sudden, temporary symptoms similar to those you described. Although these episodes resolve quickly, they can be a warning sign of a more significant stroke risk in the future.

It is also worth noting that if your symptoms are accompanied by dizziness, chest pain, or other systemic symptoms, it may warrant an immediate visit to the emergency department. These could indicate a more severe underlying condition that requires urgent intervention.

In summary, I recommend that you consult a neurologist for a comprehensive evaluation of your symptoms. They will be able to conduct the necessary tests to determine the cause of your sudden vision loss and associated symptoms. Additionally, consider scheduling an appointment with an ophthalmologist to ensure that there are no ocular issues contributing to your condition. Early diagnosis and intervention are key to managing any potential underlying health issues effectively.

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