Typical features of common causes of transient visual loss

Etiology	Typical duration	Pattern of visual loss	Associated symptoms and signs	Mechanism
Monocular ischemia, carotid disease, other embolic source	1 to 10 minutes	Monocular, rapid onset, altitudinal onset	Hollenhorst plaque, hemispheric symptoms	Retinal embolism (usually)
Giant Cell arteritis	Variable	Usually monocular	Headache, neck pain, jaw claudication	Ischemia of optic nerve
Papilledema	Seconds	Monocular graying or blurring	Headache, diplopia	Elevated intracranial pressure
Idiopathic retinal vasospasm	5 to 60 minutes	Monocular positive or negative symptoms	Transient retinal arterial narrowing, headache	Vasospasm
Migraine	10 to 30 minutes	Usually binocular, positive symptoms with spread	Usually followed by migraine headache	Spreading cortical depression, possibly retinal vasospasm
Vertebrobasilar ischemia	1 to 10 minutes	Homonymous hemianopia	Isolated or accompanied by other brainstem deficits	Embolic
Seizure: Ictal	3 to 5 minutes	Binocular, lateralized, positive phenomenon common	Altered consciousness, motor symptoms	Epileptic discharge
Postictal	20 minutes, longer	Binocular visual field loss	Preceding ictus	Cortical inhibition

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