The "what do I do now?" question is only really pertinent in the case of comms failure -- if you've still got comms, the answer is clearly "as directed by ATC", because you pose the question to ATC.
So for the comms failure case, what do you do?
Acceptance of a visual approach is conditional on a reasonable assurance that a visual approach and landing can be completed. Thus the approach is almost certainly made in VMC.
The comms failure procedure when in VMC is to continue the flight in VMC and land. Here, I think that means a visual circuit. If the conditions make it impossible to fly a visual circuit, that makes it:
a) an emergency situation not foreseen by standard procedures, requiring appropriate ad hoc action from commander and ATC alike
and
b) a situation that the pilot might like to think about before he next accepts a visual approach
