Losing the vision of an eye, even without pain, is never trivial. It would even be the main sign of an emergency called stroke of the eye in which you can lose your sight for good. So you have to react quickly! Explanation with Dr Gérald Kierzek, emergency artist and medical director of True Medical.
One eye can also make a stroke
The stroke of the eye, also called arterial or retinal venous occlusion, corresponds to a brutal interruption of blood circulation in the vessels of the retina. In question: a blood clot (thrombosis) or vascular compression (ischemia). “As for a brain stroke, every minute counts, because the retina is a fabric very sensitive to the lack of oxygen” announces Dr. Kierzek.
There are several forms, with more or less severe consequences.
The most feared is the occlusion of the central artery of the retina (OACR). “It is the equivalent of an eye infarction. The main artery, which irrigates the retina, dirts suddenly, causing a Sudden, painless and almost total vision loss of an eye “. The vision becomes black or extremely vague. Without rapid reinstatement of traffic, lesions become irreversible in a few hours.
The most frequent: the occlusion of the central vein of the retina (OVCR). “”Here, the blood drainage system is blocked. The drop in vision can be brutal or progressive, often less severe than in the OACR. However, it is not benign: it can be accompanied hemorrhages and retinal edemasometimes causing final consequences “.
Finally, some occlusions affect only a arterial or venous branch, affecting only part of the retina. This causes a scotoma, a blind area in the visual field.
A symptom, several causes
Whatever the nature of a sudden drop in vision, it is essential to consider it as an emergency. The causes of these occlusions are multiple, but almost always refer to a poor vascular health. Atherosclerosis (plaques deposits in the arteries), embolism (coillot coming from the heart or carotids), hypertension, diabetes, glaucoma, coagulation disorders or inflammation of the vessels (vascularitis) are all risk factors.
Dr. Kierzek insists: “A stroke of the eye never occurs by chance. It can be the first sign of a more general cardiovascular problem “. A complete assessment is therefore essential, with electrocardiogram, ultrasound of carotids, blood assessment …
Limited but essential treatments
What treatment if it happens to you? In the case of the OACR, the acute treatment remains controversial. “”No strategy has shown obvious efficiency to restore vision beyond 4 to 6 hours, it is often catastrophic. We can try to lower intraocular pressure, or even administer anticoagulant treatments or thrombolysis, but Le prognosis remains dark “.
On the other hand, for the OVCR, targeted treatments exist. An anti-VEGF eye can be inject into the eye to reduce edema, use laser or corticosteroid in severe ischemia. Visual improvement is possible, but often partial, and complications may persist, such as macular edema or neovascularization.
The right reflex: consulting in an emergency
“A sudden loss of vision must be considered an absolute emergency” insists our expert. In the event of a symptom, you must immediately consult an ophthalmologist or go to the emergency room.
“The faster the intervention, the more the chances of saving the vision – and of preventing other strokes, in particular cerebral – are greater. A stroke of the eye is an alarm signal that you have to know how to recognize and take seriously. Not only to preserve vision, but also to avoid much more serious cardiovascular events”.