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What is a retinal artery occlusion?

A retinal artery occlusion is a blockage of one of the blood vessels in the eye causing loss of vision. This is the same as having a ‘stroke’ to the eye.

The blockage can be to the main or smaller arteries and is usually from a cholesterol plaque or blood clot. If the blockage is in the central retinal artery, it can also be from an inflammation of the blood arteries known as temporal arteritis.

What are the risk factors for retinal artery occlusion?

  • Advanced age
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Obesity
  • Smoking
  • Irregular heartbeat
  • Inflammatory/immune diseases

What are the symptoms of a retinal artery occlusion?

  • Sudden and painless loss of vision ranging from part to all of your vision.
  • The blockage may be preceded by temporary visual loss, like a curtain coming down over the eye, which resolves with time.  (Refer to Amaurosis fugax factsheet for more information.)

How is a retinal artery occlusion diagnosed?

An eye examination will look at the back of your eyes to check for blocked arteries and other changes. You will also need the following tests:

  • Blood tests to check for risk factors and to exclude inflammatory/immune disease
  • Ultrasound of your carotid arteries (carotid doppler)
  • Heart tracing (ECG) to look for an irregular heartbeat
  • CT-scan of your brain to check for stroke
  • Temporal artery biopsy if temporal arteritis is suspected. This is a procedure where we take a sample of the temporal artery from the upper side of your head to examine under a microscope.

What is the treatment of a retinal artery occlusion?

  • If a blockage from a plaque is detected early, treatment can include acute eye massage or medications to lower eye pressure.
  • Blood thinners and cholesterol lowering medications may be prescribed, or their dosage increased if you already take them.
  • If your doctor suspects temporal arteritis then steroids may be used.

What are the risks of a retinal artery occlusion?

  • Developing abnormal blood vessels in the eye which can cause bleeding, pain and elevated eye pressure.
  • An increased risk of stroke.

Things to remember

It is important that you:

  • follow up with a stroke doctor and your GP for ongoing treatment.
  • do not drive for a period of at least four weeks and up to three months depending on what is recommended by your doctor. This is Australian law.
  • attend follow up appointments with your eye care provider and contact them if you have any further vision loss or eye pain.
  • remember the signs of a stroke (F.A.S.T; see below) and call 000 immediately if you are concerned. Do not wait to see if you get better.
F.A.S.T tips for identifying if someone is having a stroke and CALL 000.
F:Check there Face, A: Can they lift their Arms, S: Is their speech slurred, T:Time is critical, call 000 now!

What follow up do I need? (Doctor to complete)

Eye Clinic: [  ] No [  ] Yes ______________________
Stroke Clinic: [  ] No [  ] Yes ______________________
GP: [  ] No [  ] Yes ______________________

 

Disclaimer This document describes the generally accepted practice at the time of publication only. It is only a summary of clinical knowledge regarding this area. The Royal Victorian Eye and Ear Hospital makes no warranty, express or implied, that the information contained in this document is comprehensive. They accept no responsibility for any consequence arising from inappropriate application of this information.

  • Retinal Artery Occlusion #223
  • Owner: Emergency Department
  • Last Reviewed: August 13, 2020
  • Next Review: August 13, 2023