eye disorders
Central Retinal Artery Occlusion and Branch Retinal Artery Occlusion
Key Points
Central or branch retinal artery occlusion can be caused by an embolus (eg, due to atherosclerosis or endocarditis), thrombosis, or giant cell arteritis. Painless, severe loss of vision affects part or all of the visual field. Confirm the diagnosis by doing funduscopy (typically showing a pale, opaque fundus with a red fovea and arterial attenuation). Immediately refer patients with acute thromboembolic events to a specialized stroke center. Reserve color fundus photography andfluoresceinangiography and search for an embolic source by doing Doppler ultrasonography and echocardiography for subacute cases. Treat immediately if possible with ocular hypotensive drugs (eg, topicaltimololor IV or oralacetazolamide), intermittent digital massage over the closed eyelid, anterior chamber paracentesis, or hyperbaric oxygen if available. 