Retinal artery occlusionCentral retinal artery occlusion; Branch retinal artery occlusion; CRAO; BRAO; Vision loss - retinal artery occlusion; Blurry vision - retinal artery occlusion
Retinal artery occlusion is a blockage in one of the small arteries that carry blood to the retina. The retina is a layer of tissue in the back of the eye that is able to sense light.
The retina is the light-sensitive layer of tissue at the back of the eyeball. Images that come through the eye's lens are focused on the retina. Th...
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Clots may travel from other parts of the body and block an artery in the retina. The most common sources of clots are the heart and carotid artery in the neck.
Most blockages occur in people with conditions such as:
- Carotid artery disease, in which the two large blood vessels in the neck become narrowed or blocked
- Heart rhythm problem (atrial fibrillation)
- Heart valve problem
- High levels of fat in the blood (hyperlipidemia)
- High blood pressure
- Intravenous drug abuse
- Temporal arteritis (damage to arteries due to an immune response)
If a branch of the retinal artery is blocked, part of the retina will not receive enough blood and oxygen. If this happens, you may lose part of your vision.
Sudden blurring or loss of vision may occur in:
- All of one eye (central retinal artery occlusion or CRAO)
- Part of one eye (branch retinal artery occlusion or BRAO)
The retinal artery occlusion may last for only a few seconds or minutes, or it may be permanent.
A blood clot in the eye may be a warning sign of clots elsewhere. A clot in the brain may cause a stroke.
Exams and Tests
Tests to evaluate the retina may include:
- Examination of the retina after dilating the pupil
- Fluorescein angiography
- Intraocular pressure
- Pupil reflex response
- Retinal photography
- Slit lamp examination
- Testing of side vision (visual field examination)
- Visual acuity
General tests should include:
- Blood pressure
- Blood tests, including cholesterol and triglyceride levels and the erythrocyte sedimentation rate
The triglyceride level is a blood test to measure the amount of triglycerides in your blood. Triglycerides are a type of fat. Your body makes some t...
- Physical examination
Tests to identify the source of a clot from another part of the body:
- Heart monitor for abnormal heart rhythm
- Duplex Doppler ultrasound of the carotid arteries
There is no proven treatment for vision loss that involves the whole eye, unless it is caused by another illness that can be treated.
Several treatments may be tried. To be helpful, these treatments must be given within 2 to 4 hours after symptoms begin. However, the benefit of these treatments has never been proven, and they are rarely used.
- Breathing in (inhaling) a carbon dioxide-oxygen mixture. This treatment causes the arteries of the retina to widen (dilate).
- Massage of the eye
- The clot-busting drug, tissue plasminogen activator (tPA)
The health care provider should look for the cause of the blockage. Blockages may be signs of a life-threatening medical problem.
People with blockages of the retinal artery may not get their vision back.
Complications may include:
- Glaucoma (CRAO only)
- Partial or complete loss of vision in the affected eye
- Stroke (due to the same factors that contribute to retinal artery occlusion, not due to the occlusion itself)
When to Contact a Medical Professional
Call your provider if you have sudden blurring or vision loss.
Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk of retinal artery occlusion. These include:
Coronary artery disease
Stable angina is chest pain or discomfort that most often occurs with activity or emotional stress. Angina is due to poor blood flow through the blo...
- Eating a low-fat diet
- Stopping smoking
- Losing weight if you are overweight
Sometimes, blood thinners may be used to prevent the artery from becoming blocked again. Aspirin or other anti-clotting drugs are used if the problem is in the carotid arteries. Warfarin or other more potent blood thinners are used if the problem is in the heart.
Crouch ER, Crouch ER, Grant TR. Ophthalmology. In: Rakel RE, Rakel D, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 17.
Duker JS. Retinal arterial obstruction. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier; 2014:chap 6.18.
Reiss GR, Sipperley JO, Gaitan JR. Glaucoma associated with retinal disorders and retinal surgery. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3;chap 54E.
Sanborn GE, Magargal LE. Arterial obstructive disease of the eye. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3;chap 14.
Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 423.
Retina - illustration
The retina is the internal layer of the eye that receives and transmits focused images. The retina is normally red due to its rich blood supply.
Review Date: 3/15/2016
Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.