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Sudden painless blur in one eye of a hypertensive 70-year-old

Colour fundusintermediate

A 70-year-old with hypertension noticed a painless blur in one eye over a day. Acuity 6/24 in that eye.

Central retinal vein occlusion: Flame and blot haemorrhages in all four quadrants

Two panels from the source figure: A, the colour photograph; B, the fluorescein angiogram.

Diagnosis

Central retinal vein occlusion

  • Flame and blot haemorrhages in all four quadrants
  • Dilated, tortuous retinal veins
  • Swollen disc and macular oedema
  • The angiogram frame shows blocked fluorescence from the haemorrhage and the delayed venous filling