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Central Retinal Vein Occlusion, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

Disease characterized by decreased visual acuity resulting from venous occlusion of any etiology 

Etiology

  • Ischemic CRVO:

    • 20–25% of cases

    • Blocked venous return leads to backflow in capil...

Diagnosis

Signs and Symptoms

Classic description: 
  • Acute, unilateral, painless vision loss

  • “Blood and thunder” appearance on fundoscopy

History

  • Painless, unilateral vision loss

  • If nonischemic, may be incomp...

Treatment

Pre-Hospital

No specific interventions need occur prior to arrival at the hospital in regard to the eye. 

Initial Stabilization/Therapy

  • Initiate steps to lower intraocular pressure (IOP) if it ...

Follow-Up

Disposition

Admission Criteria

Patients may be admitted for surgical intervention, depending upon the ophthalmologist. 

Discharge Criteria

Patients can be discharged from the ED as long as they ...

Pearls and Pitfalls

  • Increased IOP resulting from neovascularization and edema can cause vascular insufficiency and with delayed treatment vision loss can be permanent.

  • When patients present with bilate...

Additional Reading

  • Beran  DI, Murphy-Lavoie  H. Acute painless vision loss. J La State Med Soc.  2009;161(4):214–223.

  • Di Capua  M, Coppola  A, Albisinni  R, et al. Cardiovascular risk factors and ...

Codes

ICD9

362.35 Central retinal vein occlusion 

ICD10

  • H34.811 Central retinal vein occlusion, right eye

  • H34.812 Central retinal vein occlusion, left eye

  • H34.819 Central retinal vein occlusion, unspecifie...

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