Retinal Vein Occlusion
Retinal vein occlusion is one of the most common causes of sudden, painless vision loss, occurring when a vein in the retina becomes blocked. It causes haemorrhage, macular swelling, and progressive vision loss if not treated promptly. Learn the symptoms, causes, and when specialist assessment is required.
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Carol PeelWhat Is Retinal Vein Occlusion?
Retinal vein occlusion (RVO) occurs when one of the veins carrying blood away from the retina becomes blocked by a blood clot. The resulting rise in venous pressure forces blood and fluid into the surrounding retinal tissue, causing haemorrhage, swelling, and — when the macula is affected — significant central vision loss.
There are two main types. Branch retinal vein occlusion (BRVO) affects a smaller tributary vein, causing localised haemorrhage and partial visual field loss. Central retinal vein occlusion (CRVO) blocks the main retinal vein at the optic disc, producing widespread haemorrhage across all four quadrants of the retina and often more severe vision impairment.
Macular oedema — fluid accumulation in the central retina — is the most common cause of vision loss in both types and is the primary target of treatment. Anti-VEGF injections, delivered directly into the vitreous cavity, reduce oedema and preserve vision in the majority of patients when started promptly.
Symptoms of Retinal Vein Occlusion
Symptoms typically affect one eye and develop suddenly without pain. The severity depends on whether the macula is involved and whether the occlusion is branch or central. Urgent assessment is required as soon as symptoms appear.
Causes & Risk Factors
Retinal vein occlusion most commonly results from arterial disease compressing the adjacent retinal vein. Identifying and managing underlying systemic risk factors reduces the risk of recurrence and occlusion in the fellow eye.
High Blood Pressure and Atherosclerosis
Hardening and narrowing of the retinal arteries is the most common underlying cause of RVO. At arteriovenous crossings, a stiffened artery compresses the adjacent vein, damaging its wall and promoting clot formation.
Diabetes Mellitus
Diabetes damages retinal blood vessel walls, increasing susceptibility to venous thrombosis. Diabetic patients are also at significantly higher risk of developing macular oedema following a retinal vein occlusion.
Glaucoma
Raised intraocular pressure is strongly associated with central retinal vein occlusion. All patients diagnosed with CRVO should be assessed for glaucoma, as the two conditions frequently coexist.
High Cholesterol (Hyperlipidaemia)
Elevated blood lipids accelerate atherosclerosis and arterial stiffening, increasing the risk of retinal vein compression at arteriovenous crossing points and subsequent thrombotic occlusion.
Blood Clotting Disorders
Thrombophilia and other hypercoagulable conditions, including antiphospholipid syndrome and hyperhomocysteinaemia, increase the risk of RVO, particularly in younger patients without conventional cardiovascular risk factors.
Age
RVO predominantly affects adults over the age of 50, with prevalence increasing significantly with advancing age. Age-related arterial stiffness and accumulating cardiovascular risk factors drive the higher incidence in older adults.
Diagnosis and Assessment
Diagnosis is confirmed by clinical examination and retinal imaging. A thorough systemic assessment is essential to identify contributing cardiovascular risk factors and guide medical management alongside specialist eye treatment.
Dilated Fundus Examination
The retina is examined through a dilated pupil to identify the hallmark features of RVO, including flame-shaped haemorrhages, cotton wool spots, disc swelling, and venous dilation. This allows classification into branch or central occlusion.
OCT Imaging
Optical coherence tomography identifies and quantifies macular oedema, the primary treatable cause of vision loss in RVO. OCT guides treatment decisions and monitors the response to anti-VEGF or steroid therapy at each follow-up visit.
Fluorescein Angiography
Dye-based retinal imaging documents areas of capillary non-perfusion, retinal neovascularisation, and vascular leakage. This informs decisions about retinal laser treatment and helps identify patients at risk of neovascular complications.
Systemic Investigation
Blood pressure measurement, fasting glucose, lipid profile, full blood count, and coagulation studies are arranged to identify and manage underlying cardiovascular and haematological risk factors that may have contributed to the occlusion.
When to Seek Advice
Seek urgent same-day assessment if you experience any of the following:
- Sudden, painless blurring or loss of vision in one eye
- A dark or shadowed area in any part of your visual field
- Straight lines appearing distorted or wavy
- A sudden increase in floaters, particularly dark spots or strings
- Reduced vision that does not recover within a short period
- Any episode of sudden visual change, even if it appears to resolve
“Retinal vein occlusion can cause rapid, permanent vision loss if macular oedema is not treated promptly. Urgent same-day assessment allows timely intervention and significantly reduces the risk of lasting visual impairment.”
Treatment Options
These are the treatment options available at The Eye Doctor Clinic for retinal vein occlusion and its complications.
Anti-VEGF Intravitreal Injections
Anti-VEGF intravitreal injections are the first-line treatment for macular oedema secondary to retinal vein occlusion. They block the abnormal vascular permeability driving fluid accumulation, reducing oedema and improving central vision in most patients.
Learn moreSteroidal Intravitreal Injections
Steroidal intravitreal injections and sustained-release implants reduce macular oedema in patients who have not responded adequately to anti-VEGF therapy. They provide durable inflammation control and are particularly useful in the management of chronic or refractory RVO-related oedema.
Learn moreRetinal Surgery
Vitreoretinal surgery may be required in cases complicated by vitreous haemorrhage, tractional retinal detachment, or neovascular complications that cannot be managed with injections alone. Early surgical intervention prevents further structural damage to the retina.
Learn moreMeet the Team
Where to Find Us
Three convenient locations across West Yorkshire. Visit us for consultations, diagnostics, and treatments.
Bolton
136 – 140 Newport St
Bolton, Greater Manchester
BL3 6AB
Huddersfield
Woodlands, 4 Longbow Close
Huddersfield, HD2 1GQ
Book a Retinal Vein Occlusion Assessment
If you have experienced sudden vision loss or distortion in one eye, an urgent specialist assessment at The Eye Doctor Clinic will confirm the diagnosis and arrange prompt treatment to protect your remaining vision.
