Page 56 - Demo

Case Study 7: Central Retinal Artery OcclusionScenario:A 70-year-old man with a history of hypertension and smoking presents with sudden, painless loss of vision in his right eye that occurred 2 hours ago. On examination, you note a relative afferent pupillary defect in the right eye. Fundoscopy reveals a pale retina with a cherry-red spot at the fovea.Clincher:The sudden onset of painless vision loss, combined with the characteristic fundoscopic appearance of a pale retina with a cherry-red spot, is pathognomonic for central retinal artery occlusion.Explanation:Central retinal artery occlusion (CRAO) is an ocular emergency caused by obstruction of the central retinal artery, leading to retinal ischemia. The classic fundoscopic finding of a pale retina with a cherry-red spot occurs due to the contrast between the ischemic, pale retina and the intact choroidal circulation visible at the fovea. The relative afferent pupillary defect indicates unilateral optic nerve or extensive retinal dysfunction. Urgent management is crucial, as the retina can only survive about 90-100 minutes of complete ischemia before irreversible damage occurs.