Strokes don’t only happen in the brain. They can also happen in the eyes. This type of stroke is called retinal artery occlusion.
Blood vessels carry vital nutrients and oxygen to every part of your body. When those vessels narrow or get blocked by a blood clot, the blood supply is cut off. The affected area can suffer serious damage, known as a stroke.
In the case of an eye stroke, the blockage affects the retina. The retina is the thin film that lines the inner surface of the back of your eye. It sends light signals to your brain so you can understand what your eyes see.
When the retinal veins are blocked, they leak fluids into the retina. This causes swelling, which prevents oxygen from circulating and impacts your ability to see.
An obstruction in your main retinal vein is called a central retinal vein occlusion (CRVO). When it happens in one of your smaller branch veins, it’s called a branch retinal vein occlusion (BRVO).
Continue reading to learn the symptoms, causes, and treatment for eye stroke.
Symptoms of eye stroke can develop slowly over hours or days, or they can come on suddenly. The biggest clue to retinal stroke is if your symptoms occur only in one eye. These may include:
- Floaters, which appear as small gray spots floating around in your field of vision. Floaters happen when blood and other fluids leak and then clump up in the fluid, or vitreous, in the middle of your eye.
- Pain or pressure in the eye, though eye strokes are often painless.
- Blurry vision that steadily worsens in a part or all of one eye.
- Complete vision loss that happens gradually or suddenly.
If you have symptoms of eye stroke, contact your doctor right away, even if they seem to be clearing up. Without treatment, an eye stroke can lead to permanent vision loss.
An eye stroke is caused by obstructed blood flow that damages the retina. This is usually due to either narrowing of the blood vessels or a blood clot.
It’s not always clear why eye stroke occurs, but certain health conditions, such as high blood pressure and diabetes, can increase your risk.
Certain medical conditions also increase your risk of eye stroke. These include:
- problems that affect blood flow, such as high blood pressure and high cholesterol
- other cardiovascular diseases
- narrowing of the carotid artery or neck artery
- rare blood disorders
Smoking increases the risk of all types of stroke.
Your doctor will start by dilating your eyes for a physical examination. They will use an ophthalmoscope, also called a fundoscope, to take a detailed look inside your eye.
Other diagnostic testing may include:
- Optical coherence tomography (OCT), an imaging test that can detect swelling of the retina.
- Fluorescein angiography. For this test, a dye is injected into your arm to help highlight blood vessels in your eye.
Since problems with your eyes can be caused by underlying disease, you may also be tested for glaucoma, high blood pressure, and diabetes. Your heart health may also need to be checked. If you’ve already been diagnosed with one of these conditions, it may affect your treatment for eye stroke.
Your treatment will depend on how much damage was done by the stroke. Another consideration is your overall health. Some possible therapies include:
- massaging the eye area to open up the retina
- clot-busting drugs
- anti-vascular endothelial growth factor drugs, which are injected directly into the eye
- corticosteroids, which can also be injected into the eye
- pan-retinal photocoagulation therapy if you have new blood vessel formation after an eye stroke
- laser treatment
- high pressure, or hyperbaric, oxygen
The sooner you start treatment, the better your chances of saving part or all of your vision. Any other conditions that cause blood clots will also have to be treated.
You can recover from an eye stroke, but there can be serious complications such as:
- Macular edema, or inflammation of the macula. The macula is the middle part of the retina that helps with sharpness of vision. Macular swelling can blur your vision or lead to vision loss.
- Neovascularization, a condition in which new, abnormal blood vessels develop in the retina. These can leak into the vitreous and cause floaters. In severe cases, the retina can become completely detached.
- Neovascular glaucoma, a painful increase in pressure in the eye due to the formation of new blood vessels.
Because of the potential for serious complications from an eye stroke, you’ll need to follow up with your doctor as recommended. You may need monitoring for a year or more. Be sure to report any new symptoms to your doctor right away.
You’ll also need to monitor other health conditions that can affect your eyes. If you have heart problems or diabetes, follow your doctor’s recommendations. Consume a balanced diet, get regular exercise, and maintain a healthy weight.
You may regain your vision after an eye stroke. Most people are left with some vision loss. Some cases can lead to blindness.
If you think you or someone you know is having an eye stroke, seek immediate medical attention. You can’t always prevent an eye stroke, but there are a few things you can do to lower your chances.
- Monitor your diabetes. Work to keep your blood glucose within the optimal range as advised by your doctor.
- Treat your glaucoma. Glaucoma raises the pressure in your eye, increasing the risk of eye stroke. Medicines can help keep the pressure under control.
- Keep tabs on your blood pressure. High blood pressure increases the risk of all types of stroke. Lifestyle changes can make a difference. A variety of effective blood pressure medications are also available.
- Check your cholesterol. If it’s too high, diet and exercise can help bring it down. If necessary, you can take medication to control it.
- Don’t smoke. Smoking can increase your risk of all types of stroke.