Ophthalmology · Pathway 7
Retinal Artery Occlusion
Key points
- Central retinal artery occlusion (CRAO): sudden painless loss of vision; cherry-red spot at the macula with pale retina; RAPD.
- Branch retinal artery occlusion: sectoral visual field loss.
- Immediate measures (within hours): ocular massage, anterior chamber paracentesis, lower IOP — evidence limited; treat as ocular stroke.
- CRAO is a stroke equivalent — urgent stroke workup (carotid, cardiac); exclude GCA in > 50s with raised ESR.
- Giant cell arteritis in the elderly → immediate high-dose steroids.
Decision points in this pathway
- Age > 50 with headache/raised ESR?
The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.