A transient blackout, including postural hypotension and transient cerebral ischaemia, may be present. Patients feel dizzy, black in front of their eyes and have blurred vision, symptoms usually recover within an hour and they tend to be middle-aged and elderly people with atherosclerosis, hypertension and cervical spondylosis. The anterior segment of the eye and fundus examination are usually unremarkable. In this case, ophthalmology should be consulted to rule out ocular disease and then follow the advice of the ophthalmologist to treat the primary cause.