Acute visual loss is a mutual complaint with variable presentations amid patients of different ages. The degree of difference diagnoses of vision loss is immense. Generally, monocular vision loss regularly specifies an ocular problem. Binocular vision loss is commonly cerebral in origin. Monocular vision loss can respect the horizontal midline. Binocular vision loss can respect the vertical midline. Many diverse causes of sudden visual loss are recognized; though, the most common cause for painless visual loss is ischemia. Vision loss with positive scotoma may be seen with migraine. Vision loss with a negative scotoma may be seen with amaurosis fugax.  Ischemia, often via mechanical obstruction, can affect any aspect of the visual system. Those who develop ischemia of the eye often have other evidence of atherosclerotic disease, such as coronary artery disease and peripheral vascular disease, which increases their susceptibility to ischemic events in other parts of the body. Risk factors include smoking, hypercholesterolemia, and hypertension.