Hello and welcome to Case of the Day! I’m Dr. Croley and today we’re gonna discuss a case about where a person came in, en elderly person came in with a sudden loss of vision and we end up examining their eye, and they have what’s called a branch retinal vein occlusion.
So today we’re gonna discuss branch retinal vein occlusion. If someone has a sudden loss of vision, then this is something that can be a cause of that. Basically, what happens is that the blood that our artery pumps back onto your retina, and then there’s veins that then drain the blood back out the retina to the optic nerve.
What happens in some cases is that the arteries that crosses over the vein, especially in people who have hypertension, atherosclerosis, that crossing can obstruct the blood flow and then it hemorrhages back into the retina because the blood is backed up, then causes damage to the retina in that area and loss of vision.
So people who are diabetic, people who have high cholesterol, people who have hardened arteries or atherosclerosis and hypertension are at risk of having this happen. If that does happen, then you do need to make sure that your blood pressure is okay; that you don’t have an abnormally viscous blood so 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 kind of things. Sometimes we put people on aspirin or certain blood thinners when this occurs to try to help the blood flow of that channel of the vein to open back up.
Typically, the vision can be anywhere from not too much if it’s a smaller area. The macula, the central part of your vision, right in the middle of your vision, that part of your retina is not affected, then the vision loss may not be that significant to severe loss. In someone who then hemorrhages and swells into their macula, the central part of their vision, then they can have significant loss of vision.
Initially, typically, we just follow these cases to see if the channel, 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. So in some cases then, LASER treatment supplied to the area where the bleeding has happened. And as if we can decrease the amount of swelling in the macula to improve the vision. If that’s not working well, then sometimes, what happens is 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 range out of your eye and cause a severe form of neovascular glaucoma. And so laser treatment can be done to prevent that from happening. And also, the anti-VEGF drugs that are used commonly for macular degeneration can be used in these cases at times.
If these demons will still not go away in the macula and still causing blurred vision, then injections of cortisone in the eye can then calm the eye down and get return of vision.
Some people, like I said, may have small amount of vision loss to lethally blind to severe loss, but typically after a while, the retina does tend to heal and the vein does open back up or there’s a new channel that’s developed that go around the blockage and once you look into an eye a lot of times maybe a year or two later, it’s even harder to tell if anything happened to the eye.
This is not a rare thing, it does happen fairly commonly. If it does and you have a sudden loss of vision, then you need to get to an eye doctor right away to make sure that something else isn’t going on and to be followed closely to make sure you don’t develop other problems, such as neovascular glaucoma from this disease process.
So if you have any questions about branch retinal vein occlusions, you can always contact us through the website. If not, may God bless you with healthy eyes and great vision.