Losing your sight is one of the most frightening experiences a person can have. But doctors warn that there is a neurological and vascular emergency that often begins just like that: without pain, but with serious consequences if not recognized quickly. It is about the eye vascular accident, a condition that can lead to the permanent loss of sight.
Its symptoms are often blurred vision, dark spots or, rarely, eye discomfort. Some patients come to the doctor after the therapeutic window has been exceeded, precisely because the lack of pain creates the false impression that it is not an emergency. Ocular vascular accidents are associated with an increased risk of stroke in the following months, which turns this ophthalmological event into a major alarm signal for the entire vascular system.
Why eye stroke occurs and who is at risk
Eye stroke has the same underlying causes as stroke. Atherosclerosis, hypertension, diabetes, smoking and atrial fibrillation significantly increase the risk of occurrence. Blood clots can form in the carotid arteries or in the heart and migrate to the retinal arteries, blocking circulation.
Sudden, painless loss of vision in one eye, the most important symptom
The most common and characteristic symptom of ocular stroke is the sudden, painless loss of vision in one eye. This symptom, described by patients as a “curtain” covering the visual field, occurs mainly in the occlusion of the central retinal artery or in the occlusion of its branches, forms considered the ophthalmological equivalents of a stroke. Unlike acute glaucoma or eye inflammation, eye stroke does not cause pain, redness or tearing.
Sudden blurred or distorted vision
Another common symptom is blurred or distorted vision that comes on suddenly and does not correct with blinking or changing position. Straight lines may appear wavy, objects may be distorted or partially “erased” from the field of view. This type of manifestation appears especially in retinal venous occlusions or in transient ischemia of the retina. Blurred vision may be intermittent at first, giving the impression that the problem is resolving itself. In reality, these episodes may represent transient ocular ischemic attacks, considered precursors to a complete ocular stroke or a classic stroke.
Black spots, missing areas in the field of view or sudden decrease in contrast
Some patients do not lose their vision completely, but notice the appearance of fixed black spots, areas where they no longer perceive the image or a sharp decrease in contrast. These signs indicate damage to specific portions of the retina and can occur depending on the location of the blockage. A sudden decrease in contrast, especially in low light, is an important indication that the retina is no longer receiving enough oxygen. This retinal hypoxia is the central mechanism of ocular stroke.
What needs to be done and why time is of the essence
Ocular stroke is a medical emergency. Any sudden loss of vision, even temporary, requires immediate presentation to the emergency room or an ophthalmology service with access to emergency investigations. The therapeutic window is extremely short, on the order of hours, and after this interval the chances of recovery decrease dramatically. The treatment does not only target the eye, but also the prevention of major vascular events. Investigations include evaluation of the carotid vessels, cardiac monitoring and tests for vascular risk factors.
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