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Retinal artery occlusion

How is retinal artery occlusion diagnosed?

.How is retinal artery occlusion diagnosed?

The diagnosis is suspected when a patient has acute, painless, severe vision loss. Funduscopy is usually confirmatory. Fluorescein angiography is often done and shows absence of perfusion in the affected artery.

Retinal artery occlusion

The blockage of the central retinal artery causes vision loss, after stopping the blood supply to the retina (the nerve tissue of the eye). This phenomenon is rare, and it spreads mainly among people in their sixties and above, but it may also appear in young people. In general, the infection is unilateral, and it is bilateral in only 1% – 2% of cases.

The blanching and edema are absorbed within 4-6 weeks, leaving a pallid nerve, often with a diminished ability to see. 20% of people have an extra spare artery, to ensure the blood supply, so the ability to see is only partially preserved.

Symptoms of blocked retinal artery

The symptoms of retinal artery occlusion are the feeling of a sudden sharp decline in vision, not accompanied by pain, which is represented by the ability to see ranging from the ability to count fingers and even the sense of light only. Sometimes there are telltale symptoms, which are brief and transient cases of loss of vision or vision of blackness; And there are cases, in which the injury is to one of the branches of the central artery, and thus the loss of vision is in a portion of the field of vision only.

Causes and risk factors for retinal artery occlusion

The most common cause of blockage is clots from the carotid artery, which necessitates examinations by a vascular surgeon. There are many different factors and diseases that cause blockage, such as high blood pressure, diabetes , defects in blood clotting , diseases in the heart valves, inflammatory diseases in the blood vessels, autoimmune diseases, tumors, and fatty embolisms when injured and fractures in the pelvic area. 

Complications of retinal artery occlusion

Late complications may appear: development of new blood vessels, increased risk of bleeding and secondary glaucoma.

Diagnosis of retinal artery occlusion

The diagnosis is the appearance of pale edema of the optic nerve and retinal infarct, which is the blanching of the retina, whose natural color is reddish. In the center of the blanching appears a red dot, called the red cherry point. It is a sign of central retinal artery infarction. A blockage or narrowing of the retinal arteries, which sometimes contains yellowish-white emboli.

Retinal artery occlusion treatment

Nervous tissue, which is not supplied with blood and oxygen, is subjected, within a short period of time, to irreversible damage. The mere suspicion of a blockage is an emergency situation that requires immediate treatment.

Treatment targets three things:

  1. Release the blockage.
  2. Increased oxygen.
  3. Determine the cause of the blockage.

Common treatment steps are:

a . The obstruction is released by reducing the pressure inside the eye , so that the external blood pressure pushes the emboli from the central blood vessels to the peripheral ones to reduce the damage. The common ways to reduce pressure are: 1. Filtering eye fluids. 2. Medicines to reduce pressure. 3. Massage the eyeball. 4. Medicines to widen blood vessels.

NS. Increasing oxygenation is done in several ways: 1. Suctioning the mixture of oxygen and carbon dioxide, to enable oxygen to reach the retina from nearby tissues. 2. Stay in a pressure cabin and supply oxygen in a high concentration. 3. Use of clot-dissolving agents.

NS. Determine the cause of the blockage, i.e. pay attention to the most important preventive treatment.

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