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Occlusio arteriae vel venae retinae centralis
The artery occlusion is a stroke that happened to hit the eye — so it is handled like a stroke, in minutes and hours.
Also known as: central retinal artery occlusion · central retinal vein occlusion · branch occlusion · stroke of the eye
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The retina has a single inflow and a single outflow. If one of them fails, the picture is affected at once, and which one it was can be heard in the course.
In artery occlusion, sight in one eye goes from one second to the next — all of it or a large part of the field, painless, without warning. Sometimes brief blackouts go before it. This event is the same process as a stroke in the brain, only on another branch of the same vascular tree: a clot or a crumb of calcium from the neck artery or the heart has lodged. So it belongs on the same track — straight to the clinic, not to an afternoon appointment. For the eye itself the window is very short and the outlook honestly limited; for everything else it is decisive, because the next particle can hit the brain. Over fifty, inflammation of the temporal arteries belongs ruled out the same day as well.
In vein occlusion, blood backs up instead of being missing. Sight gets worse over hours to days, blurred, as if behind a veil, often noticed on waking. It does not hurt. Behind it usually stand high blood pressure, raised pressure inside the eye or thickened blood. Here it is not about minutes but about weeks: sight hangs on whether the centre of the retina soaks up fluid, and that is exactly what can be treated.
Both forms also occur as branch occlusions — then not everything is missing but a section, often an upper or lower half of the field. That is more easily overlooked and means the same thing.
Three figures from the guideline explain the speed. **After about four and a half hours** the damage to the inner retinal layers is largely no longer reversible — which is why the same haste applies here as with a stroke in the brain, and why care belongs in a place with monitoring, a stroke unit or a comparable ward, not in an outpatient appointment. **In up to 15 in 100 cases** a brief, passing loss of vision went before and resolved on its own — whoever had that has already been warned and should not let it pass. And **if inflammation of the temporal arteries lies behind it, the second eye is affected without treatment in about 60 in 100 cases, with treatment in about 15** — that is the whole reason inflammatory blood values are measured the same day. With this caveat: **in about 4 in 100 of those affected these values are normal** while the inflammation is running. A normal blood result does not rule it out.
Do not ring the eye practice and wait for an appointment, but go to the emergency department or eye clinic, at once. The reason is less the eye than what can come next: in some of those affected an event in the brain follows in the days after.
When exactly was the sight gone — on waking, while reading, at what time? That one detail steers everything else, because it says how much time has passed. It cannot be reconstructed, it has to be written down.
Neck arteries on ultrasound, heart rhythm over a longer period, blood pressure, blood sugar, blood fats. Over fifty, ESR and CRP in addition. This is not an add-on; it is the actual point of the whole thing.
Sight hangs on whether the centre of the retina fills with fluid. That is exactly what effective treatments exist for, and they are repeated over months. The agreed check-ups are no formality here — they are the treatment.
Raised pressure is a risk factor for vein occlusion and can itself arise as a late consequence, when the retina answers the lack of oxygen with new, unfit vessels. So it is checked at the start and then regularly.
In artery occlusion there is no fading and no blurring. Sight in one eye is there and then it is not, painlessly. The moment can usually be named to the minute — and that is exactly the detail that is needed.
A slowly increasing veil, blurred print, sight as if through frosted glass, often noticed in the morning: that points to the backing-up in the vein. It too belongs looked at quickly, but it does not count in minutes.
In a branch occlusion a section drops out — often the upper or lower half, with a surprisingly straight edge. With both eyes open it is often noticed late, because the other eye fills the gap.
For some the event is preceded by passing darkenings in the same eye, seconds to minutes long. That is the same process in miniature — and the chance to act beforehand.
As with retinal detachment every outward sign is missing. An eye that hurts or is red points elsewhere — and an eye that neither hurts nor is red rules nothing out.
Over fifty, taken at once: inflammation of the temporal arteries can cause the same artery occlusion and, untreated, takes the second eye as well.
The value the deposit in the neck artery hangs on — the commonest source of the particle that caused the blockage.
Blood sugar over two to three months; it belongs to the vascular work-up and often turns up abnormal here for the first time.
AWMF 045-013 · S2e · 2022-10 — in force
Retinale arterielle Verschlüsse (RAV)
checked 2026-09