Retinal vascular occlusion: The Daily PANCE Blueprint

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Retinal vascular occlusion: The Daily PANCE Blueprint

A 62-year-old female with a history of hypertension and hyperlipidemia presents to the ER due to sudden vision loss in one eye. It isn’t painful. She tells you it felt like a “curtain was closing over her eye.” On exam you notice a cherry red spot at the fovea centralis. Which of the following is the most likely diagnosis?

A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Retinal detachment
D. Acute angle closure glaucoma
E. Hypertensive retinopathy

Answer and topic summary

The answer is A. Central retinal artery occlusion

Retinal artery occlusion is defined as occlusion of the retinal artery leading to retinal ischemia. It is usually caused by a thromboembolic event but can also be due to a vasculitis or arterial vasospasm. Clinical features include sudden but painless vision loss in one eye. Classically it is like a “curtain closing.” On exam, you may appreciate a gray discoloration of the entire retina with a cherry-red spot located at the fovea centralis. It is an ophthalmologic emergency, and treatment should be initiated STAT as permanent damage can occur in only 1.5 hours.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Vascular disorders (PEARLS) ⇒ Retinal vascular occlusion (Lecture)

Also covered as part of the Family Medicine EOR topic lists

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