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Temporary white-out in one eye

I'm male, 49, 6' tall, 160 lbs, in good shape and generally healthy. In 2004 I had surgery to graft an ascending aortic aneurysm, I returned to full activity. I now take 50 mg of Metoprolol and 150 mg of Avapro daily. My BP is generally normal, but can dip to as low as 90/60 after endurance exercise in the summer.

Three times since my surgery (including last night), I've experienced temporary complete loss of vision in one eye, I think it was my right eye each time. My vision transitions from normal to completely whited-out, and then back to normal, over about a 10 minute period. I note no other symptoms during this period and my BP is normal. I also on more frequent occasions experience red-out of my vision in one or both eyes. This comes on slowly, from the edges of my visual field and can progress to cover most of the field. This is often associated with low post-exercise BP. In both cases, I find that getting up and walking around, and drinking a large amount of water seems to help reverse the effect. I note no other associated symptoms

My cardiologist has no explanation for what is happening. My eye doctor has Optimap photos of my entire retina that go back to 2000, before my surgery, there are no abnomalities, and my interocular pressure is normal.

My family history has my mother and grandmother both having controllable glaucoma, with onset in the late 60's, both are deceased.

Any explanation of what is going on with my vision would be appreciated. The red-outs I understand, they seem to be due to low BP due to post-exercise dehydration and a refractory drop in pressure. The white-outs I have no explanation for and I cannot find any references to similar conditions.
16 Responses
233488 tn?1310696703
MEDICAL PROFESSIONAL
That is a worrisome story. I would see a neuro-ophthalmologist. You can find one near you by going to www.aao.org.

I'm surprised your cardiologist is not more unsettled by these symptoms.  My feeling is that you will need an echo cardiogram, carotid doppler and and MRI/MRA of the head and blood work to include a sedimentation rate and C-reactive protein to at least tell you its nothing to worry about now.

Loss of vision in the eye is a big time symptom that necessitates a full court press to find the cause. One time the eye could go out and the vision not come back.

Find a neuro-ophthalmologist and have him/her and your cardiologist work through the testing. If they don't find anything and the episodes continue see a neurologist.

JCH III MD
Avatar universal
Thanks for the reply, I'll see a neuro-opthamologist about this. I've had multiple echocardiograms, multiple MRA follow-up's for my aortic surgery, two stress echo's, and a carotid doppler. All have been normal and show that the repair is fine and I have no blockages or other issues. I also should note that I have severe myopia, about -10.0 diopters in both eyes with no significant astigmatism, and I wear both glasses (95% of the time) and contacts with no problems. I'm also don't have Marfan's or Ehler-Danlos, and have had a normal slit-lamp exam with no lens displacement.
233488 tn?1310696703
MEDICAL PROFESSIONAL
------------------
Avatar universal
FYI, I just set up an appointment with a local neuro-opthamologist, thank you very much for the web reference, it made it simple to find a specialist.
233488 tn?1310696703
MEDICAL PROFESSIONAL
You're welcome. Hope it turns out well. If you find out something definite let us know. This can be a learning experience for all of us.
Merry Christmas
JCH III MD
Avatar universal
I have just experienced the exact event. For the first time. Complete whiteout in right eye after waking in seated position, having exercised for an hour in a gym a few hours earlier. I am also on Metoprolol 50mgm daily, CAB graft ten years ago. I am male, 78, 73.5 kg, BP controlled by Simvastatin. Newly diagnosed type 2 diabetic not requiring medication.
Since I occasionally suffer syncope due to either (or both) orthostatic hypertension and hypo(I think)glycaemia, whiteouts are not uncommon to me, but always bilateral till today. I assume this is a TIA of the left optic nerve? No glaucome or headaches, but over the past few years have experienced some peculiar ocular things such as a massive scotoma, scintillation, and transient hypnopompic xanthopsia (for a few minutes after waking, everything seen in bright yellow). I'm myopic, but don't normally wear my glasses. I suppose, strictly, a whiteout can't be termed a loss of vision, even though I could only see a bright white light with apparently (according to my wife) no pupillary dilatation and only a vague outline of close objects in bright sunlight for the few minutes before normal vision was restored.
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