Confirm the loss, localize the problem, and identify what needs treatment now. Assess retinal ischemia and GCA in parallel when both are plausible; completing the eye examination must not delay an indicated stroke or GCA pathway.
The Algorithm…
01 Confirm / Localize
- Each Eye Separately: Acuity + fields; compare with baseline and establish last known well
- Monocular / Homonymous / Bilateral? Localize before choosing the pathway; sudden homonymous loss → cerebral-stroke assessment
- Eye Examination: Pupils, red reflex, and fundus; ocular pain / redness → painful-eye assessment
- Vision Returned? Suspected retinal TIA still requires urgent ischemia assessment
02 R/O Emergent Diagnoses
- CRAO / Retinal Arterial Occlusion? Abrupt painless monocular loss → stroke-center evaluation + urgent ophthalmology
- CRAO-specific treatment discussion—not automatic thrombolysis
- GCA? Age ≥50 + ischemic visual symptoms → assess jaw claudication, headache / scalp symptoms, and PMR
- Strong suspicion + acute / transient visual ischemia → steroids now; do not wait for laboratory results or biopsy
- Retinal Detachment? New flashes / floaters + curtain or field loss → immediate retina contact / same-day assessment
- Preserved central vision or negative POCUS does not remove the need for a specialist retinal examination
- Cerebral Stroke? Sudden homonymous defect → stroke activation, even without weakness or aphasia
03 Other Urgent Diagnoses
- CRVO / BRVO: Retinal hemorrhages + dilated tortuous veins → prompt ophthalmology
- Vitreous Hemorrhage: Haze / floaters + obscured fundus → urgent retina assessment; a tear / detachment may be hidden
- NAION: Painless loss + swollen disc / altitudinal defect → ophthalmology; assess GCA before accepting the nonarteritic label
- Macular Disease: Central distortion / scotoma → retina assessment / OCT
- Other Optic Neuropathy: Color loss / RAPD without a retinal explanation → optic-nerve assessment
- Resolved Loss / Unexplained Acute Loss: Continue the appropriate urgent assessment—not reassurance from symptom resolution or a normal-appearing fundus
Confirm / Localize
Acuity / Fields / Timing
- Visual Acuity: Test each eye with the patient’s usual glasses; compare with baseline.
- Pinhole: Repeat reduced acuity through a pinhole.
- Improvement suggests a refractive contribution—not an explanation for a new field defect or other concerning finding.
- Fields: Check confrontation fields in each eye. Normal central acuity does not exclude meaningful vision loss. Vision-Loss Examination Review
- Timing: Establish last known well, symptom discovery, sudden versus progressive onset, and whether loss persists.
- Resolved blackout / dimming: Suspected retinal TIA → urgent ischemia assessment, including GCA when appropriate. See Retinal TIA. NANOS — Transient Vision Loss
One Eye Or Both?
- Monocular: Loss remains confined to one eye when the other is covered → ocular media, retina, or optic nerve.
- Homonymous: The same right or left field is missing in both eyes, even when the patient reports “one-eye blindness.”
- This localizes behind the optic chiasm; sudden onset → cerebral-stroke assessment.
- Bilateral: Assess cerebral and bilateral ocular / optic-nerve causes. Do not force the presentation into the monocular pathway. Acute Monocular Vision Loss — Clinical Review
Painful Or Painless?
- Angle Closure? Severe ocular pain, red eye, halos, headache, or nausea / vomiting → assess the anterior segment and IOP.
- Inflammation / Infection? Pain, photophobia, or redness → assess corneal disease, uveitis, scleritis, or intraocular infection.
- Pain with eye movement supports optic neuritis / orbital disease.
- Next Action: Slit-lamp / anterior-segment examination and IOP when appropriate; use the painful-eye pathway.
- Open globe suspected: Avoid tonometry and ocular pressure. Vision-Loss Examination Review
- Headache ≠ Ocular Pain: GCA may cause headache / scalp tenderness while the visual loss remains painless. BSR 2020
Pupils / Red Reflex / Fundus
- RAPD: A relative afferent pupillary defect supports asymmetric optic-nerve or substantial retinal dysfunction—not optic-nerve disease alone.
- Swinging-Light Test: Moving light from the unaffected to the affected eye produces less constriction or apparent dilation of both pupils as afferent input falls. EM:RAP — Pupillary Defect
- Color / Fundus: Compare color perception; assess the disc, retinal vessels, hemorrhage, and retinal elevation.
- A normal-appearing disc does not exclude retrobulbar optic neuropathy. Acute Monocular Vision Loss — Clinical Review
- Red Reflex: Compare both eyes. A dim / absent reflex with an obscured fundus suggests an opacity, such as cataract or vitreous hemorrhage.
- Assess the cornea and lens for another explanation.
- A preserved reflex does not exclude retinal or optic-nerve disease. Stanford — Fundus Examination
R/O Emergent Diagnoses
Central Retinal Artery Occlusion — CRAO
General
- Acute Retinal Ischemic Stroke: Interrupted arterial flow can cause permanent visual loss. CRAO is an eye emergency and a vascular warning—not an isolated ophthalmology referral. AHA 2021
- Source: Usually thromboembolic, often from ipsilateral carotid disease or a cardiac source.
- GCA can also cause arterial occlusion: Assess in parallel; arteritic disease requires different immediate treatment. Dattilo Et Al., 2018
Clinical / Red Flags — What Moves The Needle?
- Onset: Abrupt, painless monocular loss over seconds to minutes, often severe. Establish whether it persists or has resolved.
- Central island preserved: Cilioretinal supply may preserve central acuity despite substantial field loss.
- Branch retinal artery occlusion — BRAO: A sectoral deficit still requires urgent ischemia assessment. ASRS — Retinal Artery Occlusion
- Vascular / Embolic Risk: Carotid disease, AF, valvular disease, prior vascular events, hypertension, diabetes, dyslipidemia, or smoking supports suspicion.
- Absence of known risk factors does not exclude a convincing presentation. AHA 2021
- Prior Transient Loss: A preceding monocular blackout may represent retinal ischemia. Ischemic transient monocular loss / amaurosis fugax is a retinal TIA—not reassurance because vision returned. Dattilo Et Al., 2018
- RAPD / Fundus: RAPD, retinal whitening, a cherry-red spot, attenuated arteries, or an embolus support the diagnosis.
- Early findings may be subtle or absent. Do not require a cherry-red spot or visible embolus before stroke activation. Bénard-Séguin Et Al., 2026
- GCA? Age ≥50 → ask about jaw claudication, headache / scalp symptoms, PMR, and systemic illness. No headache does not exclude arteritic disease. See GCA. ACR/VF 2021
Diagnosis
- Eye Examination: Document acuity, pupils / RAPD, fields, and retinal findings. Confirm true monocularity; a homonymous defect redirects toward cerebral stroke.
- Ophthalmology: Urgent dilated examination / retinal confirmation.
- Fundus photography or OCT may clarify subtle findings; OCT can show acute inner-retinal swelling.
- Do not delay stroke-center evaluation while awaiting confirmation. Bénard-Séguin Et Al., 2026
- GCA Testing: ESR / CRP + CBC / platelets in the appropriate age / clinical context.
- Normal markers do not independently exclude GCA. Strongly suspected arteritic visual ischemia → treatment while testing proceeds. ACR/VF 2021
Critical Actions
- Stroke Activation: Establish exact last known well—not simply discovery time. Involve stroke / neurology and ophthalmology together.
- Stroke Workup: Assess associated cerebral ischemia and the embolic source.
- Brain imaging: Follow the acute stroke pathway; MRI-DWI may identify cerebral infarction without another obvious deficit.
- CTA head / neck or equivalent: Assess carotid and upstream arterial disease, including dissection. Routine CTA generally does not show the retinal occlusion itself; normal CTA does not exclude CRAO.
- Cardiac assessment: ECG / rhythm monitoring for AF; selected echo for a cardiac source. Dattilo Et Al., 2018
- Strong GCA Suspicion + Visual Ischemia: Systemic glucocorticoids now + urgent ophthalmology / rheumatology. Follow the GCA treatment pathway; do not wait for biopsy. ACR/VF 2021
- IV Thrombolysis? Within 4.5 hours, immediately discuss the CRAO-specific protocol with the stroke team.
- AHA/ASA 2026 describes benefit as uncertain in otherwise eligible patients with disabling nonarteritic CRAO.
- Retinal stroke does not automatically mean IV thrombolysis. AHA/ASA 2026 — CRAO
- Traditional Maneuvers: Ocular massage, anterior chamber paracentesis, and hemodilution have no established benefit and may cause harm. Do not delay stroke / GCA assessment for them. AHA 2021
Journal Club — CRAO Thrombolysis
- THEIA 2025: In 70 randomized patients, alteplase did not significantly outperform aspirin for a three-line acuity improvement at one month. Limited power means this does not establish that benefit is impossible. Préterre Et Al.
- TenCRAOS 2026: In 78 patients, recovery to 20/100 or better at 30 days occurred in 20% with tenecteplase versus 24% with aspirin, without a significant difference. One fatal intracranial hemorrhage occurred with tenecteplase. Ryan Et Al.
Reassessment / Prevention
- Late Presentation / Vision Returned: Complete the urgent vascular assessment. Prevention and antithrombotic selection follow the mechanism, bleeding risk, and stroke-team plan. Dattilo Et Al., 2018
- Ophthalmic Follow-Up: Arrange surveillance for retinal / iris neovascularization and glaucoma, plus support for persistent visual impairment.
- New pain or redness after an initially painless event requires reassessment. ASRS — Retinal Artery Occlusion
In The Pit
- Sudden Painless Monocular Loss Concerning For CRAO: Last known well + stroke activation + urgent ophthalmology
- Do not require a classic fundus; normal CTA does not exclude CRAO
- Age ≥50: Assess GCA; strong suspicion + visual ischemia → steroids now
- ≤4.5 Hours: CRAO-specific treatment discussion—not automatic thrombolysis or ocular massage
- Resolved / Late: Urgent vascular assessment and prevention still apply
Giant Cell Arteritis — Arteritic Optic Neuropathy / Retinal Ischemia
General
- GCA: Large- and medium-vessel vasculitis, predominantly in adults ≥50. A normal temporal artery examination does not exclude it. ACR/VF 2021
- Why Vision Is Lost: Posterior ciliary artery involvement may infarct the optic nerve head → arteritic anterior ischemic optic neuropathy — AAION.
- GCA may also cause retinal arterial occlusion; this is inflammatory arterial disease, not simply another embolic CRAO.
- Immediate Threat: Established ischemic loss is often permanent. Treat to limit further loss and protect remaining vision—especially the fellow eye. Hayreh — Iowa Ophthalmology
Clinical / Red Flags — What Moves The Needle?
- Vision: Sudden painless monocular loss, often profound. Transient monocular loss or new diplopia may precede permanent loss.
- Jaw / Tongue Claudication: Pain or fatigue with chewing that improves with rest—not simply jaw tenderness.
- Head / Scalp: New headache, scalp tenderness, or a tender / thickened temporal artery with reduced pulse.
- PMR / Systemic Clues: Polymyalgia rheumatica symptoms—shoulder / hip-girdle pain and morning stiffness—or fever, fatigue, and weight loss support the pattern, not the diagnosis alone. Van Der Geest Et Al., 2020
- No Headache? Ocular GCA may lack headache, scalp symptoms, and constitutional illness. Do not require systemic symptoms before pursuing it. Hayreh Et Al., 1998
Diagnosis
Eye Examination
- Both Eyes: Record acuity, pupils / RAPD, fields, and fundus findings.
- Pale, Swollen Disc: Profound loss + pallid disc edema supports AAION.
- The examination may be nonclassic; pallor alone is not acute pallid disc swelling. Hayreh — Iowa Ophthalmology
ESR / CRP / CBC With Platelets
- Obtain Promptly: Elevated markers and thrombocytosis support GCA; interpret with symptoms and the eye examination. Van Der Geest Et Al., 2020
- Before Steroids? Draw blood first when immediately feasible. Do not delay indicated treatment or wait for results. BSR 2020
- Normal ESR / CRP: Lower probability but do not exclude a strongly suspected presentation.
Journal Club — Normal Markers In GCA
Kermani 2012: Among 177 biopsy-positive patients, seven had normal ESR and CRP without glucocorticoid exposure at testing. This biopsy-referred cohort does not establish a universal ED test-miss rate. Kermani Et Al.
Biopsy / Expert Vascular Ultrasound
- Confirm While Treating: Arrange biopsy and/or expert vascular ultrasound; neither should delay vision-protecting treatment. BSR 2020
- Temporal Artery Biopsy: Arrange promptly—ideally within two weeks of starting steroids.
- ACR/VF conditionally favors biopsy in U.S. practice, partly because ultrasound expertise varies.
- Biopsy may remain informative later; treatment does not immediately erase its diagnostic value. ACR/VF 2021
- Expert Vascular Ultrasound: Temporal and axillary arteries when suitable expertise is available.
- EULAR recommends ultrasound first. This is a dedicated vascular study—not routine ocular POCUS.
- Ideally before steroids without treatment delay, or within approximately 72 hours afterward; treatment may reduce sensitivity. EULAR 2023 Update
- Negative Test + Strong Suspicion: Specialist reassessment / further testing.
- A negative biopsy can miss segmental disease. ACR/VF 2021
Critical Actions
- Strongly Suspected GCA + Acute / Transient Visual Ischemia: Systemic glucocorticoids immediately. Do not wait for persistent loss, laboratory results, biopsy, or ultrasound. BSR 2020 — Executive Summary
- Threatened / Established Visual Loss: Methylprednisolone 500–1,000 mg IV daily, commonly for three consecutive days.
- Follow with high-dose oral therapy under the specialist plan.
- IV unavailable: Start high-dose oral glucocorticoids under the urgent specialist protocol while arranging IV treatment / transfer. Do not leave the patient untreated. BSR 2020
- Ophthalmology + Rheumatology: Contact urgently while initiating treatment.
- New transient / permanent visual loss or diplopia with suspected GCA → ophthalmic assessment as soon as possible that day—not routine referral. BSR 2020
Evidence — IV Versus Oral Glucocorticoids
ACR/VF conditionally favors IV pulses for threatened vision. Comparative benefit remains uncertain; this is not proof of universal superiority over high-dose oral treatment. ACR/VF 2021
Reassessment / Disposition
- Both Eyes: Repeat acuity / fields and assess new symptoms.
- Further loss after the first steroid dose requires immediate reassessment; treatment does not guarantee immediate protection. Hayreh — Iowa Ophthalmology
Monitored Admission
- IV Pulses / Evolving Loss / No Immediate Specialist-Directed Care: Arrange admission or transfer for treatment and reassessment. Start treatment before transfer.
- Ongoing Plan: Confirm steroid continuation, specialist follow-through, and testing.
- A resolved visual episode or normal ESR / CRP alone does not justify discharge. BSR 2020
In The Pit
- Age ≥50 + New Painless Visual Loss: Assess GCA—even without headache
- Jaw claudication or profound loss with a pale, swollen disc increases concern
- Strong GCA Suspicion + Persistent / Transient Visual Ischemia: Steroids now + urgent ophthalmology / rheumatology
- ESR / CRP + CBC / Platelets: Obtain promptly; do not wait for results or biopsy before indicated treatment
- Both Eyes: Reassess vision and arrange ongoing treatment / admission
- Further deterioration → immediate reassessment
Retinal Detachment
General
- Detachment: Retina separates from its underlying support layer. Most acute detachments follow a tear that allows fluid underneath—rhegmatogenous detachment. ASRS — Retinal Detachment
Clinical / Red Flags — What Moves The Needle?
- Pattern: New flashes / floaters followed by a curtain, shadow, or field loss, sometimes advancing centrally. Not every patient has the full sequence.
- Risk: High myopia, prior cataract / intraocular surgery, trauma, or previous detachment.
- Posterior Vitreous Detachment — PVD: Vitreous separates from the retina—not retina from the eye wall.
- PVD can cause similar symptoms and a retinal tear. Symptoms alone do not establish harmless PVD. AAO 2025 — PVD / Retinal Breaks
Diagnosis
- Eye Examination: Record acuity, pupils, and fields; arrange a dilated peripheral retinal examination.
- Preserved central acuity does not exclude peripheral detachment. AAO 2025
- Ocular POCUS: An elevated echogenic membrane tethered to the optic disc supports detachment. Useful when hemorrhage obscures the fundus.
- Negative scan: Does not exclude a retinal tear or replace the dilated examination.
- Macular status: Do not rely on ED POCUS alone to distinguish macula-on from macula-off.
- Open globe suspected: Avoid ocular ultrasound / pressure. ACEP — Ocular Emergencies
Journal Club — Ocular POCUS Limits
Lahham 2019: Prospective ED study supporting POCUS as an adjunct. Retinal tears and macula-on versus macula-off status were not specifically assessed. Lahham Et Al.
Critical Actions
- Suspected Detachment: Immediate ophthalmology / retina contact for same-day assessment. Arrange direct evaluation or transfer—not routine follow-up.
- Macular Status: Determines repair urgency and prognosis.
- Macula-on: Central retina remains attached → urgent repair planning to preserve central vision.
- Macula-off: Central retina is detached → prompt assessment / repair planning. Reduced vision is not permission to delay; the retina surgeon determines timing. ACEP — Ocular Emergencies
- Definitive Treatment: Retinal tears may require laser / cryotherapy; established detachment usually requires retinal repair. Procedure and timing follow the specialist examination. ASRS — Retinal Detachment
In The Pit
- Flashes / Floaters + Curtain: Suspect detachment → immediate retina contact / same-day assessment
- Central Vision Preserved: The macula may still be attached—do not downgrade urgency
- Negative POCUS: Does not exclude a tear; a concerning presentation still needs a dilated examination
Cerebral Stroke — Redirect From Field Testing
- Homonymous Defect: The same right or left field is missing in both eyes. This is postchiasmal—not isolated monocular retinal loss.
- Sudden Onset: Last known well + stroke activation, even without weakness or aphasia.
- A normal ocular examination does not exclude occipital stroke. See Acute Stroke. NANOS — Homonymous Hemianopia
Other Urgent Diagnoses
Central Retinal Vein Occlusion — CRVO
Deep Dive CorePendium — Central Retinal Vein Occlusion
- Pattern: Impaired venous drainage causes hemorrhage and edema. Painless monocular blur / loss varies; ischemic CRVO may cause profound loss. ASRS — CRVO
- Fundus: Widespread hemorrhages, dilated tortuous veins, and disc edema—the “blood-and-thunder” appearance.
- Branch retinal vein occlusion — BRVO produces a sectoral rather than diffuse pattern. RCOphth 2022
- Next Action: Prompt ophthalmology / retina assessment; review BP, diabetes, and other vascular risks.
- Macular edema is commonly treated with intravitreal anti-VEGF. ASRS — CRVO
- Confirmed isolated CRVO: Not a CRAO reperfusion indication; systemic anticoagulation is not routine solely for CRVO. RCOphth 2022
- Pain / Redness / Elevated IOP: Assess neovascular glaucoma, particularly after ischemic CRVO → urgent ophthalmic treatment. ASRS — CRVO
Vitreous Hemorrhage
Deep Dive CorePendium — Vitreous Hemorrhage
- Pattern: Painless haze, cobwebs, floaters, or variable loss; blood may obscure the fundus. Blood explains the obscured view—not why the eye bled. ASRS — Retinal Tears
- Red Reflex / Fundus: A dim reflex and hazy fundus support an opacity, including hemorrhage.
- Assess the cornea and lens for another explanation; an abnormal reflex is not diagnostic of hemorrhage. Stanford — Fundus Examination
- Retina Obscured: Urgent ophthalmology / retina assessment.
- A retinal tear / detachment may be hidden; specialist ophthalmic ultrasound may be needed.
- Do not wait for the blood to clear. See Retinal Detachment. ASRS — Retinal Tears
- Ocular POCUS: Mobile vitreous echoes swirling with eye movement support hemorrhage.
- Assess for associated detachment; a negative scan does not exclude a tear or replace specialist examination.
- Open globe suspected: Avoid ocular ultrasound / pressure. ACEP — Ocular Emergencies
Nonarteritic Anterior Ischemic Optic Neuropathy — NAION
- Pattern: Optic-nerve-head ischemia causes painless monocular loss and disc swelling.
- An altitudinal defect—upper or lower field loss—supports the pattern but is not required.
- GCA First: Age ≥50 → assess arteritic disease before accepting “nonarteritic.”
- Concerning symptoms / findings → urgent GCA assessment / treatment. No headache does not exclude GCA.
- Next Action: Prompt ophthalmology / neuro-ophthalmology confirmation.
- No proven acute vision-restoring treatment. Do not automatically apply CRAO reperfusion or GCA steroids.
- Arrange vascular-risk and sleep-apnea assessment. NANOS — NAION
Macular Disease
Deep Dive CorePendium — Acute Maculopathy
- Central Distortion / Scotoma: Wavy lines, impaired reading, or a central dark patch with relatively preserved peripheral vision suggests macular disease.
- Consider neovascular age-related macular degeneration — AMD, macular edema, or macular / submacular hemorrhage.
- New Central Loss: Prompt retina assessment + optical coherence tomography — OCT.
- Suspected acute hemorrhage → urgent discussion.
- Do not attribute sudden deterioration to chronic AMD without reassessment. ASRS — AMD
Other Optic Neuropathies
Deep Dive CorePendium — Optic Neuritis
- Optic Neuritis: Color desaturation and pain with eye movement support the diagnosis; painless presentations occur.
- Ophthalmology / neuro-ophthalmology assessment + appropriate brain / orbital MRI. NANOS — Optic Neuritis
- Compressive / Infiltrative Disease: Usually progressive rather than abrupt.
- Unexplained optic-nerve dysfunction → specialist-directed investigation / imaging. A normal-appearing retina does not end the assessment. Stanford — Compressive / Infiltrative Optic Neuropathies
Vision Loss Resolved — Retinal TIA?
- Pattern: Sudden monocular dimming, blackout, or a curtain that clears may be retinal ischemia.
- Return of vision and a normal examination do not exclude retinal TIA.
- Clarify The Episode: Onset, duration, recovery, and one eye versus both. Not every transient visual symptom is ischemic.
- Ischemia Suspected: Urgent brain / vascular / cardiac assessment; assess GCA in patients ≥50.
- Use the CRAO assessment, TIA pathway, and GCA section as appropriate. NANOS — Transient Vision Loss
Acute Loss Still Unexplained?
- Persistent Acute Loss: Urgent specialist assessment. A normal-appearing fundus is not a diagnosis; reassess localization and arrange the testing needed to explain the deficit. Acute Monocular Vision Loss — Clinical Review
Must-Read References
View Full References
Retinal Arterial Ischemia
- AHA/ASA 2026 — Acute Ischemic Stroke Guideline, including the CRAO recommendation. IVT benefit remains uncertain in eligible disabling nonarteritic CRAO within 4.5 hours.
- Mac Grory Et Al. — AHA CRAO Statement, 2021. Emergency retinal-stroke evaluation and prevention; interpret treatment alongside newer trials.
- Kovach Et Al. — AAO Retinal And Ophthalmic Artery Occlusions PPP, 2025. Specialty guidance on retinal arterial occlusion.
- Préterre Et Al. — THEIA, 2025. Randomized alteplase-versus-aspirin trial with limited statistical power.
- Ryan Et Al. — TenCRAOS, 2026. No significant visual-recovery advantage with tenecteplase; serious bleeding concern.
Giant Cell Arteritis
- Maz Et Al. — ACR/VF 2021. U.S. confirmation and treatment guidance; IV-over-oral preference for threatened vision is conditional.
- Mackie Et Al. — BSR 2020. Immediate treatment, acute / intermittent visual loss, and same-day ophthalmic assessment.
- Dejaco Et Al. — EULAR 2023 Update. Published in 2024; expert temporal / axillary ultrasound and early imaging after steroid initiation.
Retinal Detachment / Ocular Ultrasound
- AAO 2025 — PVD, Retinal Breaks, And Lattice Degeneration PPP. U.S. guidance on retinal-break assessment and management.
- ACEP — Ocular Emergencies, Sonoguide. POCUS findings, limitations, and globe-injury precautions.
Other Retinal / Optic-Nerve Disease
- Nicholson Et Al. — RCOphth RVO Guideline Executive Summary, 2022. Ocular treatment, vascular-risk assessment, and limits of routine antithrombotics.
- ASRS — Retinal Tears. Hemorrhage and hidden retinal tears / detachments.
- NANOS — NAION. Arteritic differential, treatment limitations, and risk assessment.
- NANOS — Transient Vision Loss. History and urgent stroke-style assessment when ischemia is suspected.
Additional Cited Guidance
Retinal Ischemia / Examination
- Dattilo, Newman, And Biousse, 2018. Retinal TIA, vascular sources, and brain / vascular / cardiac assessment.
- Bénard-Séguin Et Al., 2026. Diagnostic / retinal-imaging review; its treatment discussion predates some newer trial results.
- ASRS — Retinal Artery Occlusion. Anatomy, retinal findings, and complications; acute treatment follows current guidance and trials.
- Clinical Reviews — Vision-Loss Examination / Acute Monocular Vision Loss. Examination and localization resources retained from the source chapter.
- EM:RAP — Pupillary Defect. Author-supplied swinging-light examination resource.
- Stanford — Fundus Examination. Red reflex, ocular opacities, and examination limits.
Giant Cell Arteritis
- Van Der Geest Et Al., 2020. Combined interpretation of symptoms, examination, and laboratory tests.
- Hayreh Et Al., 1998. Ocular GCA without systemic symptoms.
- Kermani Et Al., 2012. Biopsy-positive disease despite normal inflammatory markers.
- Hayreh — Iowa Ophthalmology. Ocular findings and prognosis; drug regimens follow newer society guidance.
- NANOS — GCA. Recognition of arteritic visual loss.
Retinal / Optic-Nerve Disease
- Lahham Et Al., 2019. Prospective ED POCUS study; retinal tears and macular status were not specifically assessed.
- ASRS — Retinal Detachment / CRVO / AMD. Recognition, specialist treatment, and complications.
- NANOS — Optic Neuritis / Homonymous Hemianopia. Optic-nerve assessment and postchiasmal localization.
- Stanford — Compressive / Infiltrative Optic Neuropathies. Progressive optic-nerve dysfunction and targeted imaging.