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Acute Persistent Visual Loss: Retinal Artery Occlusion

Arterial occlusion

What causes it?
Sudden thrombotic or embolic blockage of this vessel cuts off oxygen to the inner retina. Vision loss is painless.

Look for a milky white retina with a cherry-red spot at the fovea. These changes appear four or more hours after the visual loss. If the patient is examined earlier, the fundus may appear normal.

What to do?
Try to lower intraocular pressure in hopes that the clot will move distally. Massage the globe with the index fingers of each hand (five seconds pressure, five seconds release) 20 times in order to reduce its pressure.

Acute anticoagulation is not recommended because this is a completed stroke. Infusion of thrombolytic agents is still experimental.

To learn more, go to Principal Ophthalmic Conditions: central retinal artery occlusion.

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