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Retinal Artery Occlusion

What Is Retinal Artery Occlusion?

The blood vessels that feed the retina run like the branches of a tree. An abrupt blockage of blood flow (ischemia) halts proper retinal functioning, which results in visual impairment. Depending on the extent and location of the retina affected, the loss of vision may be relatively mild or very severe. This problem is analogous to a "stroke" of the eye.

What Treatment is Available for Retinal Artery Occlusion?

Unfortunately there is no treatment that has been clinically proven to restore blood flow and improve vision. Sometimes there will be limited, spontaneous improvement in vision, but if this occurs it will be apparent within the first few days.

Can Retinal Artery Occlusion Worsen?

Sometimes patients with a retinal artery obstruction develop a severe form of glaucoma (neovascular) that can cause complete loss of vision and a painful, red eye. Although uncommon, this glaucoma is often very severe. Usually, warning signs will develop within the eye before the glaucoma sets in. These warning signs usually occur without symptoms, so it is critical that close, careful follow-up be maintained for the first few months in order to catch them. If they should develop, laser treatment is warranted. It is important to understand that the laser treatment does not help to improve vision; it is intended to reduce the risk of developing neovascular glaucoma.

Do I Require Further Testing?

In general, patients with either a “central” (i.e. main artery) or “branch” retinal artery obstruction require medical evaluation by an internist or cardiologist to identify a source for the blockage. Often it is the result of atherosclerosis (hardening of the arteries), in which a fragment of cholesterol or clot breaking off from a larger artery elsewhere in the body, such as in the neck or heart, travels through the circulation until it obstructs a retinal artery in the eye.

Blood tests or other diagnostic tests such as an ultrasound of the heart and neck may be warranted. Sometimes a blood thinning medication such as aspirin, Plavix, or Coumadin is prescribed to reduce the risk of new clots and blockages. Although this would not help improve sight in the affected eye it could have long-term benefit for your general health.

Are there any restrictions or precautions?

There is no reason to limit most daily activities such as reading, watching TV, etc. However, when one has blurred vision in one eye for any reason, one’s depth perception is hampered. To the degree that this is true, one should be careful doing anything which requires the ability to judge distances such as working around machinery, climbing on ladders and scaffolds, pounding nails, pouring hot liquids, and driving. It is relatively uncommon for a similar process to affect the other eye, and blurry vision in one eye does not in any way harm the “good” eye.