Isolated bilateral blindness as the sole manifestation of transient ischaemic attacks

. Purpose:  To explain the rare phenomenon of acute transient bilateral blindness without additional ophthalmological or neurological symptoms and signs. Methods:  Six patients with isolated bilateral visual loss lasting 1–15 mins and occurring simultaneously in both eyes were evaluated. Clinical observation, neuroimaging (CT, MRI, MR-angiography), extra- and transcranial Doppler and vascular risk factors assessment were performed. Results:  Cortical blindness due to bilateral occipital lobe transient ischaemic attacks (TIAs) was established as the most likely cause of acute transient visual loss in all patients. Conclusion:  We suggest that in cases of transient bilateral blindness with sudden onset, appearing simultaneously in both visual fields, a bilateral ischaemia of the visual cortex should be suspected even if other neurological symptoms are lacking. Patients should be managed in the same way as patients with vertebrobasilar TIAs.