A 82-year-old female presented with history of loss of vision in right eye for about 15 minutes and it cleared up. She has a history of diabetes and hypertension. She had which showed old infarct on right side. Carotid duplex showed that patient had 99% carotid artery stenosis. Which one of the following statements is TRUE?

**Core Concept**
Transient monocular blindness, also known as amaurosis fugax, is a condition where a patient experiences temporary loss of vision in one eye due to a transient reduction in blood flow to the retina. This occurs when there is a significant stenosis or occlusion of the carotid artery.

**Why the Correct Answer is Right**
In this patient, the 99% carotid artery stenosis is the likely cause of the transient monocular blindness. The stenosis reduces blood flow to the retina, leading to a temporary decrease in vision. This is a classic symptom of carotid artery disease and is often described as a curtain or shade descending over one eye. The patient's history of hypertension and diabetes also increases the risk of carotid artery disease.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because the patient's symptoms are not consistent with a migraine aura, which typically involves visual disturbances such as flashing lights or zigzag patterns.

**Option B:** This option is incorrect because the patient's symptoms are not consistent with a retinal detachment, which typically involves a sudden loss of vision in one eye accompanied by flashes of light and floaters.

**Option C:** This option is incorrect because the patient's symptoms are not consistent with a stroke, which typically involves a sudden and persistent loss of vision in one eye, accompanied by other symptoms such as weakness, numbness, or difficulty speaking.

**Clinical Pearl / High-Yield Fact**
Amaurosis fugax is a warning sign of carotid artery disease and increases the risk of stroke. Patients with a history of transient monocular blindness should be evaluated for carotid artery disease and considered for carotid endarterectomy or angioplasty to prevent future strokes.

**Correct Answer:** C.

✓ Correct Answer: A. 60%chance that extra cranial carotid artery stenosis is the cause of transient ischemic attack (TIA)