Eyes & Vision

Central Retinal Artery Occlusion (CRAO)

Central retinal artery occlusion is an ocular stroke causing sudden, painless monocular visual loss; it needs immediate stroke and ophthalmology assessment, with urgent exclusion and treatment of giant cell arteritis when clinically suspected.

Definition

Central retinal artery occlusion is acute obstruction of the central retinal artery causing ischaemia and infarction of the inner retina with sudden, usually painless monocular visual loss. It may be non-arteritic, usually embolic or thrombotic, or arteritic from giant cell arteritis, and is managed as an ocular stroke.

First principles

The central retinal artery supplies the inner retina

The central retinal artery supplies most of the inner retina. Abrupt loss of perfusion causes retinal ischaemia and can leave permanent severe visual loss, so CRAO is time-critical even though the eye is usually white and painless.

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