Central retinal vein occlusion

[beckyforbes]

I am a 43 year old woman who was diagnosed with a central retinal vein occlusion after having blurred vision in my eye for about a week.  I'm not diabetic, I don't have high blood pressure, I'm not a smoker and I'm not overweight.  I do have slightly high cholesterol and I have been on birth control pills for 20 years.  I discontinued the birth control pills when I got this diagnosis.  My opthalmologist has referred me to a hematologist to have a hypercoagulable workup.  I am also wondering if I should schedule an appointment with my primary care physician to have my carotid arteries tested.

[Kl83]

Hi I wonder could anyone give me advice please. My dad has been diagnosed with retinal artery occlusion. The doctors have done all the tests and say they can't do anything for him. It is getting worse everyday and unfortunately he lost the sight in his other eye years ago in an accident so he is nearly blind. Do you know if there is anything anywhere that could help him or is there a chance it may improve. Thank you

[JohnHaganMD]

It depends on where the artery occlusion is: the main or "Central" retinal artery occlusion (CRAO)  is usually blocked by emboli (or traveling clots) often from a diseased carotid artery. If it is a CRAO the prognosis is poor and the treatment is difficult even if it happened in an ophthalmologist's office. I would suggest you get him to the closest outstanding medical university  center with a department of ophthalmology to see a retina specialist for a second opinion. remember that if a CRAO did happen due to an emboli a search needs to be done for the cause and the heart, blood vessels and blood itself need to be examined. There is a very high incience of subsequent strokes in situations like this.  If a smaller branch retinal artery occlusion BRAO then sometimes improvement over time occurs or treatment can be helpful if not curative.

[JohnHaganMD]

Please notice that the prognosis, cause and treatment are totally different if an artery is occluded or whether a vein is occluded.

[John C Hagan III, MD, FACS, FAAO]

It is virtually impossible for a workout to cause swelling of the lids which causes CRVO.  I doubt if your retina MD would put any physicial restrictions on your activities. You might call and ask.  On the other hand I can't think of why your eyes would swell unless hair coloring, facial cosmetics or dye from your sweatband were causing a reaction.

Ask the retina MD when you're in.

JCH MD

[beckyforbes]

I have one additional question, Dr. Hagan.  For the past few years, I've noticed that when I work out, specifically when I run on the treadmill, by the time I'm finished with my workout, my eyes are swollen.  Sometimes it takes a full day for the swelling to go down.  Before this happened, I attributed this to either allergies or maybe a reaction between sweat and my moisturizer, but now I'm wondering if this could have any link to CRVO.  I'm scared to death now to do any strenuous exercise.  Should I refrain from running until I meet again with my retina doctor?  My next appointment is a week from today.

[John C Hagan III, MD, FACS, FAAO]

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[beckyforbes]

I will do that as well.  Thank you, Dr. Hagan.

[John C Hagan III, MD, FACS, FAAO]

Also ask your MD about a Heart CT.  In Kansas City that test is available for as little as $50.  It looks for calcium in the heart arteries which are a proxy for atherosclerosis. It is a test I have found useful personally and professionally.

JCH MD

[beckyforbes]

Thank you for the insight and information.  Trying to stay optimistic.

[beckyforbes]

Thank you, Dr. Hagan, for this information.  I just got this diagnosis two days ago.  My appointment with the hematologist is scheduled for next week.  I will contact my primary care doctor now regarding the additional testing.

[DeltaDawn23]

I had a CRVO in 1998 at the age of 53.  I had blurry vision, went in and they said it was going to get worse  before it got better.  I had been checked regularly by an opthamologist and had no idea how this could happen.  My lipid profile was high.  I lost the fine vision in that eye.  My vision is like seeing through fog or a steamy mirror.  I did have to have some laser work done bcause I developed little bleeding vessels.  I still have enough vision to walk around a room without bumping into things and to see outlines of people, but not enough to distinguish features or read.  I can't take statins, am now diabetic and am working to keep my cholesterol and sugar under control with diet and exercise. It is my understanding they can help the macular edema that sometimes comes with a CRVO now and I don't think that was an option when I had mine. According to a print out from the Kellogg Eye Center at the University of Michigan, ". . . in some cases intraocular injections, laser surgery, or an operation may be used to reduce the macular edema and stabilize or improve vision.  In severe CRVO, laser surgery is used to prevent or treat the abnormal blood vessel growth that can lead to glaucoma or bleeding, in some cases, surgery may be necessary."  I wish you luck.

[John C Hagan III, MD, FACS, FAAO]

Yes and you should strongly consider a fasting lipid profile and, since the most common cause of CRVO is compression of the CRV by an atherosclerotic CR artery strong consideration should be given to going on statins.

JCH MD