The intersection of ophthalmology and neurology: Diagnosing acute strokes through visual symptoms

Purpose: To document how acute cerebrovascular accidents (CVAs) present first to an ophthalmologist.

Methods: Retrospective, observational, unicentric hospital-based study. The electronic medical records of new patients who presented to the Neuro-ophthalmology department of a tertiary eye hospital in the month of August 2022 were reviewed. Those with symptoms suggestive of an acute stroke requiring urgent neuroimaging were chosen for further study.

Results: Out of the 710 new patients, 31 had a known CVA and presented with field defects (4.3%). We recognized nine new patients, subsequently diagnosed to have a CVA, initially presenting with ocular symptoms such as homonymous hemianopia in seven cases and two others as transient obscuration of vision and internuclear ophthalmoplegia.

Conclusion: Posterior circulation strokes commonly present first to an ophthalmologist, the early recognition of which is of utmost importance.