Central Retinal Artery Occlusion (1)

Question 1

What occurs here?

What is its main risk factor?

What is the most common cause?
→ What else can it be caused by?

If its symptoms are transient in duration, what’s it known as?

Answer 1

➊ Blockage of flow through the central retinal artery, which is a branch of the ophthalmic artery

➋ Atherosclerosis

➌ Embolus from carotids/heart
→ GCA

➍ Retinal TIA = Amaurosis Fugax

Question 2

How does it present?

What is seen O/E?

Answer 2

➊ Sudden painless loss of vision – Like a curtain/shutter across vision over seconds

➋ * Pale retina
* Cherry-red spot – The macula is supplied by the cilioertinal artery which is usually not affected in CRAO. This leaves the macula to show the red-coloured choroid below.
* RAPD – No constriction in affected eye, Constriction in normal eye

Question 3

What is important to rule out? What should be done for this?

How can it be managed?

Answer 3

➊ GCA, with ESR and Temporal artery biopsy

➋ If pt present shortly after symptoms develop, the thrombus can be dislodged:
• Ocular massage, Reduce intraocular pressure