Ophthalmology

Arterial occlusion of the eye

General

The fundus of the eye and thus the retina is supplied with blood through the central artery. The patency is absolutely necessary so that the retina receives the necessary amount of oxygen to display a perfect image.

If the central artery is blocked (arterial blockage of the eye) or the small arteries branching off from it, the patient suddenly becomes blind in the affected eye, possibly for a limited period of time. The blindness can persist until appropriate therapy has been initiated or it can only last for a short time (so-called amaurosis fugax, is considered a harbinger of arterial occlusion in the eye). However, painless blindness of the eye is always characteristic.

Causes of an artery blockage in the eye

An artery blockage in the eye can result either from deposits in the blood vessels or from a blood clot blocking the blood vessel.

Deposits arise in the context of arteriosclerosis.
Blood clots usually develop in the eye itself, but can also get into the eye from other vessels such as the carotid artery or the heart.
Another cause is diabetes mellitus.
Retinopathy, which occurs in the late stages of this disease, can also lead to occlusion of the ocular artery.
Furthermore, vascular inflammation or high blood pressure can also be the cause of an occlusion.
The closure causes a lack of oxygen in the tissue, as adequate blood flow is no longer guaranteed.
If this deficiency persists, the sensory cells perish and blindness occurs.

Concomitant symptoms

The symptoms of arterial obstruction are limited to the affected eye.
There is usually no pain.
Those affected usually report a sudden loss of vision.
However, there is the problem that the loss of vision is compensated by the brain because the other eye is not affected by the occlusion. The visual impairment can therefore be compensated for and the patient no longer notices anything of the disease until the doctor diagnoses it.

Blindness from arterial occlusion

Artery occlusion can affect either the central artery or a branch of the central artery.
If the central artery is blocked, it manifests itself as sudden, painless, one-sided blindness.
A branch artery obstruction is more likely to lead to visual field defects and impaired vision.

In both cases the cause is that the sensory cells are not supplied with enough oxygen due to the insufficient blood supply to the retina, so that they die.
Even after therapy, the chances of success in regaining sight are very poor.

Detecting a blockage of the arteries in the eye

How is an occlusion of the arteries of the eye diagnosed?

The ophthalmologist, who should be consulted immediately, is likely to make a diagnosis of central artery obstruction quickly after completing the medical interview. Then he will see the fundus of the eye with a lamp (ophthalmoscopy) and, in the case of the arteries in the eye, often see light, small cholesterol chunks at the branches of the retinal arteries. Furthermore, the vessels leaving the central artery are unusually narrow, an edema of the retina can be identified, on which a cherry-red structure (of the blind spot) stands out.

Read more on the topic: Fundoscopy

Can the arteries in the eye be cured?

Unfortunately, the prognosis for arterial occlusion in the eye is poor.
Since the arterial occlusion in most cases leads to a considerable deterioration in vision, which often ends in blindness, this usually lasts for a lifetime.
The cause is that if there is insufficient blood supply to the retina, the sensory cells are irrevocably damaged.

Treating an occlusion of the arteries in the eye

How is an artery occlusion in the eye treated?

Even with immediate therapy, the chances of success in case of an arterial occlusion of the eye are very low, since the sensory cells are irrevocably destroyed after just 60 to 90 minutes.

However, the following measures are taken to keep the permanent visual damage as low as possible:

Massage the eyeball
Lowering of intraocular pressure
Anticoagulant

The so-called fibrinolysis must be carried out on an internal medicine ward, since a close observation of the patient with an arterial obstruction of the eye is necessary. It is important that the patient is well-medically adjusted for the future by anti-coagulation or that risk factors are eliminated. This includes: