Retinal Vascualr Occulsions

Question 1

What is a retinal arterial occlusion

Answer 1

1. Atherosclerotic emboli (central or branch retinal artery)
   *common cause of vision loss

Question 2

What are the RF of retinal arterial occlusions

Answer 2

1. Rule out giant cell arteritis if over 50
2. DM / HTN
3. Evaluate for carotid or cardiac source of emboli, cardiac dissection

Question 3

What are the signs of retinal arterial occulusions

Answer 3

1. Painless, sudden monocular vision loss (amaurosis fugax)
   *island of vision in temporal field only counting fingers
2. No redness

Question 4

What will be found on PE

Answer 4

1. Visual field restricted to an island in temporal field
   *flame-shaped hemorrhages
   *cotton wool spots

Question 5

If there is a large occlusion what wil be on PE

Answer 5

1. Pale retina and a cherry red repot in area of maculae
   *pale, milky, edematous retina evidence of swelling
   *inner layer of the retina edematous expect fovea
   *box car segmentation

Question 6

What needs to happen is someone present with a retinal arterial occlusion

Answer 6

Emergent referral for ophthalmology

Question 7

What is the treatment of retinal arterial occlusion

Answer 7

Need to dislodge clot, re-vascularize
*if the obstruction can be dislodged in less than 90 minutes vision can be saved

Question 8

If the occlusion is happening in the retinal arteries what does the patient have?

Answer 8

1. Significant atherosclerotic diseases
   *at an increased risk for CVD, MI, CVA