central retinal artery occlusion

Question 1

central retinal artery occlusion causes? risks?

Answer 1

thromboembolism, inflammation (arteritis)

risks is same for thrombosis

Question 2

symptoms and signs?

Answer 2

SUDDEN COMPLETE PAINLESS vision loss in ONE EYE

RAPD:
light in affected eye: no response
light in unaffected: direct and indirect response
swinging light from unaffected to affected: dilation of affected eye (marcus gunn pupil)

fundoscopy: cherry red spot with macula and retinal pallor

Question 3

management?

Answer 3

admit pt

achieve hypotony (reduce IOP) to dislodge thrombus into a smaller vessel:
1. eye massage
2. give BB or CA inhibitor acetazolamide
3. IV mannitol

anterior chamber paracentesis
laser embolectomy, thrombolysis