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    A closer look at central retinal artery occlusion

    Management of CRAO revolves around management of the systemic disease

    A central retinal artery occlusion (CRAO) represents a true ocular emergency. It is frequently caused by an embolus originating from carotid artery disease secondary to atherosclerotic plaques. The embolus can also originate from a cardiac source. There is a poor visual prognosis for a CRAO because there is currently no effective treatment to restore vision in the affected eye.

     

    History

    A 63-year-old white male presented to the emergency room (ER) complaining of sudden vision loss in the left eye two days prior and was referred to the eye clinic for evaluation. The patient denied any symptoms of jaw claudication, sensitivity to the temporal area, flashes, floaters, pain, paresthesia, numbness, headache, or neurological deficits. The patient also denied any ocular trauma or previous history of ocular disease. The patient reported that “bits and pieces” of his vision were clear, but his superior field of vision was obscured. He could see only a “strip of vision” out of his left eye.

    Related: A closer look at the retina in multiple sclerosis

    The patient’s blood pressure in the ER that day was 187/114 mm Hg. His medical history was positive for type II diabetes mellitus and coronary artery disease. His cardiac history included bypass surgery and stenting. The patient’s blood glucose measured 134 mg/dL that day, and his last documented HbA1c was 7.7 six months ago.

    Next: Diagnostic data

    Peter Siedman, OD
    Peter Siedman, OD, is a graduate of SUNY College of Optometry and is a staff optometrist at the West Palm Beach VAMC.
    Philip Haiman, OD
    Philip Haiman, OD, is a graduate of Indiana University College of Optometry and is a staff optometrist at the West Palm Beach VAMC.

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    Optometry Times A/V