August 12, 2008
Other
Question from Vancouver, Washington, USA:
My 20-year-old college son lost his vision this May for four or five minutes. This was accompanied by a numb feeling in his head. He went to the hospital and they did an MRI. The doctor that read the MRI said he didn’t see anything, but wanted him seen by a neuroophthalmologist when he got home. He was seen by an ophthalmologist who had him get an echocardiogram, which showed a “bright spot on his aorta” and now they want my son to have an esophageal echocardiogram. Of course, my son is not crazy about this. Is there a less invasive procedure that would give them the same information? What is a bright spot on the aorta? Should I request he go to a neuroophthalmologist first? I don’t understand where my worry level should be on this. What might be the possible causes of the temporary loss of vision — a clot of some sort, something in his head, anything else? I respectfully request your insight.
Answer:
I believe the concern is that he may have had a clot that embolized from a source in the bloodstream. The source of a clot that may have broken loose could have come from the heart, including the heart valves, or a part of the aorta where there may be a malformation or defect, such as an aneurysm. I do not mean to worry you, but the history of temporary vision loss like that is a history that should be attended to with further follow-up testing to rule out a source of an embolic clot to the vessels of the eye. The reason for the esophageal echocardiogram is that the probe that is the source of the sound waves can get closer to the anatomic structures they are trying to study and give greater visualization of the areas in question (aorta, chambers of the heart, and heart valves). In this case, it sounds like an important test to have done.
JTL
