PANCE Blueprint EENT (7%)

Vascular disorders (PEARLS)

NCCPA™ PANCE Eyes, Ears, Nose, and Throat Content Blueprint eye disorders ⇒ vascular disorders

Retinal vascular occlusion Sudden, painless, unilateral, and usually severe vision loss (Amaurosis fugax)

  • Embolism from the same side (ipsilateral) carotid artery, ophthalmic artery, and heart, or giant cell arteritis
  • Rule out carotid artery stenosis by carotid ultrasound
  • Look for the cherry red spot and pale opaque fundus with red fovea and arterial attenuation

TX: Optho emergency. Immediate treatment is indicated if occlusion occurred within 24 h of presentation

  • Reduction of intraocular pressure with ocular hypotensive drugs (eg, topical timolol 0.5%, acetazolamide 500 mg IV or PO)
  • Intermittent digital message over the closed eyelid or anterior chamber paracentesis
  • If patients present within the first few hours of occlusion, some centers catheterize the carotid/ophthalmic artery and selectively inject thrombolytic drugs
Hyphema (ReelDx + Lecture) (Prev Lesson)
(Next Lesson) Retinal vascular occlusion (Lecture)
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