Central retinal artery occlusion is a relatively rare cause of sudden unilateral visual loss. It is due to thromboembolism (from atherosclerosis) or arteritis (e.g. temporal arteritis)

Features

• sudden, painless unilateral visual loss
• relative afferent pupillary defect
• 'cherry red' spot on a pale retina

Central retinal artery occlusion: note the pale retina

Fundoscopic image showing a typical cherry red spot in a patient with central retinal artery occlusion

Management is difficult and the prognosis is poor

• any underlying conditions should be identified and treated (e.g. intravenous steroids for temporal arteritis)
• if a patient presents acutely then Intraarterial thrombolysis may be attempted but currently, trials show mixed results.