A 75-Year-Old Man Comes to the Office Due to Intermittent

A 75-year-old man comes to the office due to intermittent right eye vision loss.  The patient reports 3 episodes over the past 2 months in which he suddenly experienced "a curtain falling over the right eye" for several minutes before it spontaneously resolved.  He has no eye pain or discomfort, focal weakness, numbness, or headache.  His medical history is significant for hypertension, hyperlipidemia, and osteoarthritis.  He smoked cigarettes for 25 years before quitting at age 50.  Blood pressure is 140/85 mm Hg and pulse is 74/min.  Visual acuity, pupillary reflex, and funduscopic examinations are unremarkable.  Further neurologic examination shows normal reflexes, motor strength, and sensation.  Which of the following is most likely to yield the diagnosis in this patient?

A) CT scan of the head
B) Duplex ultrasound of the neck
C) Echocardiography
D) Erythrocyte sedimentation rate
E) Lumbar puncture and CSF analysis
F) MRI of the brain
G) Ocular tonometry

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