Carotid embolization presenting as total monocular blindness.

Blindness suddenly developed in the right eye of a 55-year-old man. There had been no antecedent illness suggestive of cardiovascular disease. Funduscopic examination eight hours later showed findings consistent with central retinal artery thrombosis. After an arteriogram showed an ulcerated plaque at the bifurcation of the right common carotid artery, the patient underwent thromboendarterectomy. The specimen contained an ulcer, presumably the nidus of an embolus to the central retinal artery. The patient's vision did not recover. This case demonstrates that, although it is rare, total monocular blindness may be caused by a large embolus from a carotid artery plaque.