Symptoms

1. Decreased vision
2. Ocular pain
3. Prolonged recovery after bright light
4. Transient unilateral visual loss (amaurosis fugax)
5. Symptoms usually unilateral

Clinical signs

1. Dilated, irregular non tortuous veins
2. Narrowed retinal arterioles
3. Mid- peripheral retinal haemorrhages
4. Neovascularisation of the retina and iris
5. Episcleral injection
6. Spontaneous pulsations of the central retinal artery

Causes

1. Carotid disease (>90% stenosis)
2. Ophthalmic artery disease

Investigations

1. Fluorescein angiography
2. Doppler ultrasonography
3. Magnetic resonance angiography
4. Ophthalmodynamometry (ophthalmic artery pressure)

Management

1. Medical examination (esp CVS)
2. Fluorescent angiography
3. Surgical treatment of carotid artery stenosis
4. Laser treatment of neovascularisation
5. Control blood pressure and diabetes