5 - Opth - Acute loss of vision - Retinal Artery Occlusion

Question 1

Associated with..

Answer 1

Atherosclerosis, valve disease, DM, smoking

Question 2

Always do what???

Answer 2

exclude arteritis (with CRP/ESR)

Question 3

Central RAO - presentation

Answer 3

• sudden unilateral severe decrease in VA
• may be complete loss of light perception
• RAPD
• intermittent prodrome phase common

Question 4

Central RAO - fundoscopy

Answer 4

Pale retina (oedema) - cherry red spot (only fovea contains photoreceptors as its supplied by choroid -for 6wks)

possible signs of hypertensive retinopathy

Question 5

Central RAO - management

Answer 5

• ocular massage
• rebreathing into paper bag -> hypercapnia and vasodilatation
• acetoazolamide, paracentesis (aspiration of aq from ant chamber) -> to lower IOP

Question 6

Branch RAO - 2 features

Answer 6

variable acuity, defect may be sectoral or central

-embolus may be visible