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An elderly person came in with a sudden loss of vision. We ended up examining their eye, and they had what is called a branch retinal vein occlusion.
If someone experiences a sudden loss of vision, this can be a cause of that. Basically, what happens is that an artery pumps blood into your retina, and then some veins drain the blood back out of the retina through the optic nerve. In some cases, the arteries cross over the vein, especially in people who have hypertension or atherosclerosis, and that crossing can obstruct the blood flow. It hemorrhages back into the retina because the blood is backed up, and causes retinal damage in that area and loss of vision. People who are diabetic, have high cholesterol, have hardened arteries, or have atherosclerosis and hypertension are at risk of having this happen.
If this happens to you, then you need to make sure your blood pressure is okay and that you don’t have abnormally viscous blood. Hence, you need to have blood work done to make sure that your blood count is okay. You need to make sure your diabetes is under control and those kinds of things.
Sometimes, when this occurs, we put people on aspirin or certain blood thinners to try to help the blood flow of that channel and for the vein to open back up. Typically, the vision can be anywhere from not too much if it’s a smaller area, and then the macula, the central part of your vision, is not affected. The vision loss may not be that significant or severe. However, someone who then hemorrhages and swells into their macula, the center part of their vision, can have significant vision loss.
Typically, we just follow these cases to see if the channel or the vein will open back up on its own, and that the backed-up blood and fluid will then drain away, but many times that does not happen. In some cases, laser treatments are applied to the area where the bleeding has happened to see if we can decrease the amount of swelling in the macula.
If that’s not working, sometimes what happens is that there’s been such a loss of blood flow in the eye that the eye is stimulated to grow in new blood vessels, which then can grow into the angle where the fluid drains out of your eye and cause a severe form of neovascular glaucoma. Laser treatment can be done to prevent that from happening. Also, the anti-VEGF drugs commonly used for macular degeneration can be used in these cases at times. If this edema still does not go away and the macula is still causing blurred vision, then injections of cortisone in the eye can calm the eye down and help restore vision.
Some people’s experiences may range from having a small amount of vision loss to being legally blind/severe loss, but typically, after a while, the retina does tend to heal, and this vein does open back up, or there’s a new channel that is developed and goes around the blockage. Once you look into an eye a lot of times, maybe you’re too late, or it’s even hard to tell if anything happened to the eye.
This is not a rare thing; it does happen fairly commonly, and if you experience a sudden loss of vision, you need to get to an eye doctor right away to make sure something else isn’t going on and for your case to be followed closely to make sure you don’t develop other problems, such as neovascular glaucoma, from this disease process.
If you have any questions about branch retinal vein occlusion, you can always try to contact the Cataract & Refractive Institute of Florida through the website. If not, may God bless you with healthy eyes and great vision.
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