Sudden painless unilateral vision loss caused by branch retinal artery occlusion: implications for the primary care physician

Branch retinal artery occlusion and non-ischemic central retinal vein occlusion due to hyperhomocysteinemia in a 14-year-old child

A 14-year-old girl presented with sudden, painless loss of vision in the left eye. Complete ophthalmologic examination including fluorescein angiography revealed an impending central vein occlusion and a branch retinal artery occlusion inferotemporally. One month later, there was a non-ischemic central retinal vein occlusion of the same eye. Systemic evaluation led to the diagnosis of hyperhomocysteinemia. This case report underscores the importance of excluding hyperhomocysteinemia in vascular occlusive disease.

Approach to ophthalmologic emergencies

This article presents evaluation and treatment approaches to ophthalmologic conditions that are likely to be encountered in a primary care office. These conditions can be organized by diagnostic category, symptoms, and location of complaint. By using one ora combination of these categories, the practitioner can provide appropriate, timely, and effective ophthalmologic evaluation and treatment. Acute conditions are categorized according to urgency of intervention.