Central retinal artery occlusion

Etiology

Retinal Embolism (20%)

Atherosclerotic changes

Angiospasm

Inflammatory Endarteritis

Bilateral 1-2%

M>F

Painless, monocular loss of vision

Amaurosis fugax (painless, fleeting; nl exam)

CRVO (painless, over hours; blood and thunder)

Temporal Arteritis

Acute glaucoma (blurry vision, eye pain)

Pale retina with edema

Cherry red spot at the macula

APD

Boxcar segmentation of blood column

Fundoscopic exam

CBC, ESR, EKG

1. Ocular massage

2. Anterior chamber paracentesis

3. Intraarterial fibrinolysis

4. Acetazolamide

5. Mannitol

6. Timolol

7. Steroids

8. Hyperbarics (most effective if within 2-12h of presentation)

Admit: comorbid disease

D/C: f/u with ophtho in 1-4 weeks

H-N

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