Manual
Central retinal artery occlusion
Emergencies
Central retinal artery occlusion
Painless sudden monocular vision loss = ocular stroke.
- Sudden painless vision loss (often CF or worse), RAPD.
- Retinal whitening, cherry-red spot, box-carring; cilioretinal artery may spare central vision.
- Emboli (Hollenhorst plaques) suggest carotid source.
Send to a stroke center emergently (within 4.5 h discuss thrombolysis per local protocol). In patients > 50, check ESR/CRP/platelets for giant cell arteritis immediately.
Work-up: MRI brain (DWI), CTA/MRA head & neck or carotid duplex, ECG/telemetry, echocardiogram, lipids, HbA1c. Watch for neovascularization over the next 3 months.
Educational summary — follow local protocols and current guidelines.