Central Retinal Artery Occlusion with Sudden Vision Loss—“Ay, Ay, My Eye!”

  • Bradley M. End
  • Colin G. KaideEmail author


Sudden monocular blindness with or without macular sparing is a central retinal artery occlusion until proven otherwise. It has some characteristic findings that appear on funduscopic exam that can be pathognomonic for the diagnosis. An afferent pupillary defect is often seen indicating a decrease in light perception in the affected eye. The workup for a patient with CRAO includes evaluation for sources of emboli, inflammatory markers, and possibly testing for a hypercoagulable state. Success of treatment depends on the duration of time before treatment is initiated. Vasodilators, anterior chamber paracentesis, and ocular massage have been used as initial treatment. Intra-arterial tPA has shown some promise as a therapeutic modality. Early Hyperbaric Oxygen Therapy may temporize the patient until the obstruction resolves spontaneously or other therapies have time to work.


Central retinal artery occlusion  Central retinal vein occlusion Macular sparing Temporal arteritis Retinal detachment Retinal hemorrhage Vitreous detachment tPA  Hyperbaric Oxygen Temporal arteritis Anterior chamber paracentesis 


Disclosure Statement

  • None for Brad End

  • Colin Kaide: Callibra, Inc.-Discharge 123 medical software company. Medical Advisory Board Portola Pharmaceuticals. I have no relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in article or with a company making a competing product.

  • Portola Pharmaceuticals: No conflict with this chapter material.


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Emergency MedicineRobert C. Byrd Health Sciences Center, West Virginia UniversityMorgantownUSA
  2. 2.Department of Emergency MedicineWexner Medical Center at The Ohio State UniversityColumbusUSA

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