Vascular Disease

Blood vessels carry blood to and from the light sensitive structure of the eye called the retina. In particular blood in the retina is drained from smaller branches of retinal veins (venules) into the larger central retinal vein away from the eye. Either one or more of the smaller branches of the main, larger central retinal vein can become blocked or obstructed. Usually there is a painless loss of some peripheral an/or central vision.

Retinal venous disease can be among the top leading five causes of vision loss in the elderly in our practice. The average age of presentation is 65 years old with 85 percent of the patients above the age of 50. Similar to certain types of stroke, a partial blockage or obstruction within the blood vessel impedes the outflow of blood from the eye. Subsequently there is associated bleeding, swelling or edema into the retina. In some cases the blood flow within the smallest blood vessels called capillaries is compromised resulting in poor circulation or ischemia of the retina. If the central portion of the retina known as the macula is affected by any of these 3 complications, that is blood, edema, or ischemia, there may be irreversible loss of vision.

In patients over the age of 50, the blockage within the retinal vein typically occurs because of arteriosclerosis (hardening of the arteries). This leads to turbulent blood flow within the vein and in some cases leads to the development of a clot in the vein. I should emphasize that the clot develops within the retinal vein and does not pass to the eye from another part of the body such as the heart or carotid artery. In patients under the age of fifty, sometimes either inflammation or coagulation (clotting) disorders may pre-dispose to the development of clot and subsequent vascular obstruction. We usually recommend a more comprehensive evaluation (mostly blood tests) in younger patients who are diagnosed with this condition.

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