Retinal Artery Occlusion: Diagnosis, Symptoms, and Recovery - Ophthalmology

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Hello Dr.
Wang, I would like to ask about my condition.
I suffered a retinal artery occlusion in my right eye due to a car accident, and my vision was reduced to only hand movements.
The doctor said I could only receive supportive treatment and that I should give up hope.
However, six months later, my right eye vision recovered to 20/20.
When I inquired with the doctor at the hospital, he simply said it was a miracle and could not provide further comments.
I am very concerned that the doctor may have misdiagnosed me with an artery occlusion when I might not have had any issues at all.
Later, a doctor at a teaching hospital said it was caused by arterial vasospasm leading to temporary optic nerve dysfunction and that I didn't need further examinations.

I would like to ask:
1.
Does the retina include the optic nerve and retinal arteries?
2.
Can a dilated fundus examination reveal symptoms of retinal artery occlusion, or is it necessary to perform angiography?
3.
Is there a treatment for retinal artery occlusion?
4.
Do I need to undergo further examinations?
5.
What are the symptoms of arterial occlusion?
6.
Can a fundus examination detect arterial occlusion?
7.
What are the causes of retinal artery occlusion? Thank you for your response.

LL, 20~29 year old female. Ask Date: 2005/02/01

Dr. Wang Zhangji reply Ophthalmology


Hello: A dilated fundus examination allows us to observe the optic nerve and retinal arteries, and it can also reveal arterial occlusions.
If combined with angiography, the details can be clearer.
If there is a complete retinal occlusion and it has been present for too long, the chances of recovery are generally low.
If you have no symptoms, it is sufficient to have an examination approximately every three months.
Arterial occlusions can affect vision, and the causes may include foreign bodies traveling from other major blood vessels or, as in your case, vascular spasms due to trauma.
Sincerely, Dr.
Wang Zhang-ji, Ophthalmology.

Reply Date: 2005/02/01

More Info


Retinal artery occlusion (RAO) is a serious condition that can lead to significant vision loss. It occurs when the blood supply to the retina is blocked, typically due to a blood clot or embolism. Understanding the diagnosis, symptoms, and potential for recovery is crucial for anyone affected by this condition.

1. Understanding the Retina and Optic Nerve: The retina is a thin layer of tissue at the back of the eye that is responsible for converting light into neural signals, which are then sent to the brain via the optic nerve. The retinal arteries supply blood to the retina, and any blockage in these arteries can severely affect vision. The optic nerve, while closely related to the retina, is a separate structure that transmits visual information to the brain.

2. Diagnosis of Retinal Artery Occlusion: Diagnosis typically involves a comprehensive eye examination, including a dilated fundus examination. During this examination, an eye doctor can observe the retina and look for signs of occlusion, such as retinal edema, cotton wool spots, or a pale retina. However, to confirm the diagnosis and assess the extent of the blockage, additional tests such as fluorescein angiography may be necessary. This test involves injecting a dye into the bloodstream and taking images of the retina to visualize blood flow.

3. Symptoms of Retinal Artery Occlusion: The most common symptom of RAO is sudden, painless vision loss in one eye. Depending on the location of the occlusion, this loss can range from partial to complete. In some cases, patients may experience visual disturbances such as flashes of light or the appearance of a dark spot in their vision.

4. Potential for Recovery: Recovery from RAO can vary significantly among individuals. In some cases, as you experienced, vision may improve over time, potentially due to collateral circulation or the resolution of the blockage. However, in many instances, vision loss can be permanent. The prognosis often depends on the duration of the occlusion and the underlying cause.

5. Need for Further Examination: Given your history of RAO and the subsequent recovery of vision, it is advisable to have regular follow-up examinations with an ophthalmologist. This is particularly important if you experience any new symptoms or changes in vision. Continuous monitoring can help detect any potential complications or recurrence of the condition.

6. Symptoms of Retinal Artery Occlusion: As mentioned, the primary symptom is sudden vision loss. Other symptoms may include visual field defects or changes in color perception. If you experience any of these symptoms, it is crucial to seek immediate medical attention.

7. Causes of Retinal Artery Occlusion: The causes of RAO can vary, but common factors include atherosclerosis (hardening of the arteries), emboli from the heart (such as in cases of atrial fibrillation), or other systemic conditions like hypertension and diabetes. Trauma, such as from a car accident, can also lead to RAO due to direct injury to the eye or changes in blood flow.

In conclusion, while your recovery from retinal artery occlusion is indeed remarkable, it is essential to remain vigilant about your eye health. Regular check-ups with an eye care professional can help ensure that any potential issues are addressed promptly. If you have any concerns about your vision or the possibility of misdiagnosis, do not hesitate to seek a second opinion from a qualified ophthalmologist. Your vision is invaluable, and proactive care is key to maintaining it.

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