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Retinal artery occlusion

Central retinal artery occlusion; CRAO; Branch retinal artery occlusion; BRAO; Vision loss - retinal artery occlusion; Blurry vision - retinal artery occlusion

Retinal artery occlusion is a blockage in one of the small arteries that carry blood to the retina. The retina is a layer of tissue in the back of the eye that is able to sense light.

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Retina

Causes

Retinal arteries may become blocked when a blood clot or fat deposits get stuck in the arteries. These blockages are more likely if there is hardening of the arteries (atherosclerosis) in the eye.

Clots may travel from other parts of the body and block an artery in the retina. The most common sources of clots are the heart and carotid artery in the neck.

Most blockages occur in people with conditions such as:

If a branch of the retinal artery is blocked, part of the retina will not receive enough blood and oxygen. If this happens, you may lose part of your vision.

Symptoms

Sudden blurring or loss of vision may occur in:

The retinal artery occlusion may last for only a few seconds or minutes, or it may be permanent.

A blood clot in the eye may be a warning sign of clots elsewhere. A clot in the brain may cause a stroke.

 

Exams and Tests

Tests to evaluate the retina may include:

General tests should include:

Tests to identify the source of a clot from another part of the body:

Treatment

There is no proven treatment for vision loss that involves the whole eye, unless it is caused by another illness that can be treated.

Several treatments may be tried. To be helpful, these treatments must be given within 2 to 4 hours after symptoms begin. However, the benefit of these treatments has never been proven, and they are rarely used.

The health care provider should look for the cause of the blockage. Blockages may be signs of a life-threatening medical problem.

Outlook (Prognosis)

People with blockages of the retinal artery may not get their vision back.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your provider if you have sudden blurring or vision loss.

Prevention

Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk for retinal artery occlusion. These include:

Sometimes, blood thinners may be used to prevent the artery from becoming blocked again. Aspirin or other anti-clotting drugs are used if the problem is in the carotid arteries. Warfarin or other more potent blood thinners are used if the problem is in the heart.

Related Information

Retina
Blood clots
Glaucoma
High blood pressure - adults
Diabetes
Acquired platelet function defect
Atherosclerosis
High blood cholesterol levels
Vision problems
Blindness and vision loss
Stroke

References

Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.

Crouch ER, Crouch ER, Grant TR. Ophthalmology. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 17.

Duker JS, Duker JS. Retinal arterial obstruction. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 6.19.

Patel PS, Sadda SR. Retinal artery occlusion. In: Schachat AP, Sadda SR, Hinton DR, Wilkinson CP, Wiedemann P, eds. Ryan's Retina. 6th ed. Philadelphia, PA: Elsevier; 2018:chap 54.

Salmon JF. Retinal vascular disease. In: Salmon JF, ed. Kanski's Clinical Ophthalmology. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 13.

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Review Date: 2/25/2020  

Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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