Diagnosis of a Retinal Artery Occlusion

If you experience sudden vision loss, you should contact your ophthalmologist immediately. He or she will conduct a thorough examination to determine if you have had a retinal artery occlusion (RAO). Your ophthalmologist will dilate your eyes with dilating eye drops. This will allow him or her to examine the retina for signs of damage.

Other tests your ophthalmologist may do are:

• Fluorescein angiography. This imaging test uses a special camera to take photographs of the retina. A small amount of yellow dye (fluorescein) is injected into a vein in your arm. The photographs of fluorescein dye traveling throughout the retinal arteries show how many arteries are closed
• Intraocular pressure (pressure inside the eye)
• Reflexes of your pupil
• Other photos of the retina
• A slit-lamp examination
• Testing of side vision (visual field examination)
• Visual acuity (sharpeness), to determine how well you can read an eye chart.

Since RAOs involve other aspects of your general health, your ophthalmologist will likely communicate with your primary care provider.

People who have RAOs are at a greater risk for having a stroke (when blood flow to the brain is cut off), so your ophthalmologist or your regular doctor may order an ultrasound of your carotid arteries (the main blood vessels in your neck that send blood to your eyes and brain). An ultrasound is a medical test that uses soundwaves to create images of the organs and tissues inside your body. You might also be told to have an echocardiogram (ultrasound of the heart). Both of these tests help look for a possible source of the blockage in the retinal artery. This is best done in an emergency room, much like a stroke evaluation. 

Since RAOs are urgent health problems, they require prompt evaluation. Your ophthalmologist will also likely talk with your medical provider.

The evaluation may include:

• an ultrasound of your carotid arteries (the main blood vessels in your neck that send blood to your eyes and brain). An ultrasound is a medical test that uses soundwaves to create images of the organs and tissues inside your body.
• echocardiogram (ultrasound of the heart).

Both of these tests help look for a possible source of the blockage in the retinal artery. In most cases of CRAO, a prompt referral to a stroke center for a medical evaluation is recommended because the risk of stroke is very high during the first 1 to 4 weeks.