If the amaurosis fugax is caused by an artherosclerotic lesion, aspirin is indicated. Further surgical therapy through a carotid endarterectomy, should be done if the stenosis is surgically accesible.

If the diagnostic workup reveals a systemic disease process, directed therapies to treat that underlying etiology should be initiated. If the amaurosis fugax is caused by an atherosclerotic lesion, aspirin is indicated, and a carotid endarterectomy if the stenosis is surgically accessible. Generally, if the carotid artery is still patent, the greater the stenosis, the greater the indication for endarterectomy. “Amaurosis fugax appears to be a particularly favorable indication for carotid endarterectomy. Left untreated, this event carries a high risk of stroke; after carotid endarterectomy, which has a low operative risk, there is a very low postoperative stroke rate.”^[1] If the full diagnostic workup is completely normal, patient observation is recommended.