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Eye Strokes



Eye strokes occur when blockages (occlusions) occur in arteries or veins in the retina, causing vision loss. The severity

of vision loss depends on the extent and location of the occlusion(s) and loss of blood flow. Just as strokes occur in

other parts of the body because blood flow is blocked, your eye also may suffer damage when vital structures such as

the retina and optic nerve are cut off from nutrients and oxygen flowing through your blood.

Besides having an eye exam to detect signs of an eye occlusion, you'll also need your family doctor or internal medicine

physician to evaluate you for high blood pressure, artery disease or heart problems that may be responsible for the


If a blockage is found, the type of retinal artery or vein occlusion you have is categorized by its location.

Central Retinal Artery Occlusion (CRAO)

Central retinal artery occlusion usually occurs with sudden, profound, but painless vision loss in one eye. Most people

with CRAO can barely count fingers in front of their face or see light from the affected eye. The condition may be

preceded by episodes of vision loss known as amaarosis fugax. The cause of CRAO is most commonly a clot or embolus

from the neck (carotid) artery or the heart.

This clot blocks blood flow to the retina. CRAO is considered a "stroke" of the eye. Studies show that about two-thirds

of patients have underlying high blood pressure and one-fourth of patients will have significant carotid artery disease

(plaque with narrowing of the artery lining), cardiac valvular disease or diabetes.

In a recent German study of the underlying risk factors in patients with central retinal artery occlusion, researchers found

that previously undiagnosed cardiovascular (CV) risk factors were present in 78 percent of CRAO patients, and 67 percent

had CV risk factors in their medical history. The most meaningful unidentified risk factor was narrowing (stenosis) of the

carotid artery on the same side of the body as the eye stroke.

Also, 11 of the 84 participants in the study (13 percent) had a stroke either prior to or within one month after diagnosis of

CRAO. The study authors concluded a prompt, comprehensive, cardiovascular diagnostic work-up should be considered

mandatory for all patients with central retinal artery occlusion.

Your ophthalmologist may diagnose CRAO after an examination of the eye, including a dilated pupil exam. With CRAO the

retina will be pale and the vessels narrowed. If you are seen within the first few hours of onset, the retinal signs may not yet

be present, and a fluorescein angiogram may be required to confirm the diagnosis. This procedure, which is very safe, entails

injection of fluorescein intravenously with retinal photography afterward.



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