Retina Vein Occlusion

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What Is Retinal Vein Occlusion?

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Retinal vein occlusion (RVO) occurs when a vein carrying blood away from the retina — the light-sensitive tissue at the back of the eye — becomes blocked. When blood cannot drain properly, it backs up in the retina, causing swelling, bleeding, and reduced oxygen delivery to retinal tissue. This can affect vision suddenly or gradually, depending on the type and severity of the blockage.

There are two main types:

• Branch Retinal Vein Occlusion (BRVO): A blockage in one of the smaller branch veins, affecting a portion of the retina.

• Central Retinal Vein Occlusion (CRVO): A blockage in the main retinal vein, affecting the entire retina and generally causing more significant vision loss.

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Symptoms

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Symptoms often appear suddenly and may include:

• Blurred or distorted vision in one eye

• A dark area or blind spot in your field of vision

• Partial or complete vision loss in one eye

• Vision that is worse than usual upon waking

• Floaters (in some cases, if bleeding occurs)

RVO typically affects only one eye and is usually painless. Because sudden vision changes can indicate a serious problem, anyone experiencing these symptoms should seek prompt evaluation by an eye care provider.

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Causes and Risk Factors

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RVO is closely linked to conditions that affect blood vessels and blood flow throughout the body. Common risk factors include:

• High blood pressure (hypertension)

• Diabetes

• High cholesterol

• Glaucoma

• Age over 50

• Blood clotting disorders

• Smoking

• Cardiovascular disease

Because RVO often reflects broader vascular health, patients diagnosed with it are frequently referred for a general medical workup to identify and manage underlying conditions.

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How Is It Diagnosed?

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Diagnosis typically involves a dilated eye exam along with imaging tests such as:

• Optical Coherence Tomography (OCT): Measures retinal swelling (macular edema)

• Fluorescein Angiography: Highlights areas of poor blood flow or leakage

• Fundus Photography: Documents the appearance of the retina for monitoring over time

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Treatment Options

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There is no single cure that reverses the vein blockage itself, but several effective treatments help manage complications and preserve vision:

• Anti-VEGF Injections: Medications injected into the eye to reduce swelling and abnormal blood vessel growth. These are the most common first-line treatment and often require repeated injections over time.

• Corticosteroid Injections or Implants: Used to reduce inflammation and swelling, particularly when anti-VEGF treatment is insufficient.

• Laser Treatment (Photocoagulation): May be used to treat areas of poor blood flow or to prevent complications such as abnormal new blood vessel growth.

• Management of Underlying Conditions: Controlling blood pressure, blood sugar, and cholesterol is essential to reducing the risk of complications and, potentially, occlusion in the other eye.

Treatment plans are individualized based on the type of occlusion, degree of vision loss, and presence of complications such as macular edema or neovascularization.

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Outlook

Many patients experience meaningful vision improvement with timely and consistent treatment, though some vision loss may be permanent, especially with CRVO. Regular follow-up is essential, as RVO can lead to complications — including glaucoma and further vision loss — if left unmonitored.

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When to Seek Immediate Care

Contact your eye care provider right away if you experience sudden vision changes, a new blind spot, or a sudden increase in floaters. Early evaluation and treatment offer the best chance of preserving vision.