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Central Retinal Artery Occlusion, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Obstruction of the central retinal artery associated with sudden painless loss of vision

  • Usually occurs in persons 50–70 yr of age

  • Ophthalmic artery is 1st branch of carotid.

  • Risk facto...

Diagnosis

Signs and Symptoms

History

  • Sudden, painless, monocular loss of vision

  • Prior episodes of sudden visual loss:

    • May last a few seconds to minutes (amaurosis fugax)

    • Caused by transient embolic phenome...

Treatment

Initiate treatment immediately because irreversible visual loss occurs at 90 min: 
  • Only immediate treatment may help to salvage or restore sight to the affected eye.

  • Goals of therapy include d...

Follow-Up

Disposition

Admission Criteria

Required for workup of proximal cause in acute cases (source of embolism, thrombosis, or inflammatory) 

Discharge Criteria

Chronic retinal artery occlusion with no...

Pearls and Pitfalls

  • Amaurosis fugax (transient, possibly resolved retinal artery occlusion) is a sentinel event and may lead to complete occlusion or stroke. Do not ignore these symptoms and urgent wo...

Additional Reading

  • Arnold  M, Koerner  U, Remonda  L, et al. Comparison of intra-arterial thrombolysis with conventional treatment in patients with acute central retinal artery occlusion. J Neurol Neu...

Codes

ICD9

362.31 Central retinal artery occlusion 

ICD10

  • H34.10 Central retinal artery occlusion, unspecified eye

  • H34.11 Central retinal artery occlusion, right eye

  • H34.12 Central retinal artery occlusion...

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