Retinal Artery Occlusion

Retinal artery occlusion (RAO) is a serious eye condition. It happens when a blood vessel that carries blood to the retina gets blocked. This blockage means oxygen and nutrients can’t get to the nerve cells at the back of your eye. It happens suddenly and doesn’t cause pain, but it affects your vision and you need to get care right away.

At Banner Health, our experienced eye care specialists use advanced tools to diagnose and treat this condition quickly. Fast care may help save your vision and improve your overall health.

What is retinal artery occlusion?

Retinal artery occlusion is a blocked blood vessel in your eye. There are two main types:

• Central retinal artery occlusion (CRAO): The main artery in your retina is blocked. It often causes severe vision loss. CRAO is an eye emergency.
• Branch retinal artery occlusion (BRAO): A smaller artery in your retina is blocked. You may lose some vision, like your vision to one side. If the affected area is not in the center of your eye or is small, you might not have any symptoms. You are likely to keep fair to good eyesight.

What are the symptoms of retinal artery occlusion? 

Retinal artery occlusion usually causes sudden vision loss in one eye. The loss of vision depends on the area that’s affected:

• CRAO: You can have severe vision loss that doesn’t get better.
• BRAO: You may have blurry vision or lose some eyesight. You may still have fair to good vision.

You might also notice:

• A shadow, curtain or blank area in your vision
• That you don’t see things as clearly 
• Gray or white areas in your vision
• Eye pain (this is rare)

You should get eye care immediately for any of these symptoms.

What causes retinal artery occlusion? 

A blockage in the retinal artery causes retinal artery occlusion. This blockage is often an embolus, which is a small piece of cholesterol. It can also be a thrombus or blood clot. This clot may come from the carotid arteries in your neck or from the heart.

These factors raise your risk for retinal artery occlusion:

• High blood pressure
• Atherosclerosis, or fatty deposits in your arteries
• Diabetes
• Faulty heart valves or abnormal heart rhythms like atrial fibrillation
• Blood clotting disorders
• Giant-cell arteritis
• High cholesterol
• Smoking
• Oral contraceptives
• Being male
• Age over 60

How is retinal artery occlusion diagnosed? 

To diagnose retinal artery occlusion, your health care provider will examine your eye. They will give you eye drops to dilate (open) your pupil so they can see into your eye. 

CRAO has a “cherry red spot” where the center of the macula is red and the retina around it is pale because it’s not getting blood flow. 

BRAO has a white area along the blocked vessel. 

Your eye care provider may also suggest other eye tests and evaluations:

• Optical coherence tomography (OCT): This provides detailed images of the central retina. 
• Fluorescein angiography (FA): This shows whether the retinal arteries are filling slowly. 
• Intraocular pressure test: This measures pressure in the eye.
• Cilioretinal artery presence: Some people have this extra artery. If so, you’re likely to retain more of your vision. 

Your provider may also recommend blood tests or other imaging or monitoring studies to check for causes of retinal artery occlusion.

How is retinal artery occlusion treated? 

Retinal artery occlusion is a medical emergency. You should get care right away for the best chance of preserving your vision.

Treatment may include:

• Breathing into a paper bag to increase carbon dioxide
• Removing fluid from your eye with a needle
• Eye drops to reduce pressure in the eye
• Gentle eye massage to dislodge the clot
• In some cases, clot-busting drugs
• Hyperbaric oxygen therapy 

Retinal artery occlusion has the same risk factors as stroke and heart disease. For ongoing care, you may need:

• Treatment for the condition that caused retinal artery occlusion
• Lifestyle changes to protect your vision and your heart
• Good control of diabetes and high blood pressure
• Regular follow-up appointments

Why do you need treatment right away?

Retinal artery occlusion is an eye emergency. Getting care immediately can increase your odds of saving some of your vision.

• CRAO usually causes severe vision loss, but if you have a cilioretinal artery there’s a good chance you will recover some of your vision.
• BRAO may damage your peripheral (side) vision, but you may have fair to good central vision.

Get eye care at Banner Health

If you have sudden vision changes, get help right away. At Banner Health, we’re ready to help diagnose and treat retinal artery occlusion and other urgent eye conditions.