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A 65 year old male presents with painless loss of vision to his left eye. His fundoscopic examination is shown below. What does this show and what are the underlying causes?

INTERPRETATION

This is the ‘tomato sauce’ or ‘blood and thunder’ funds of central retinal vein occlusion. There are tortuous vessels and significant retinal haemorrhages.

This causes a painless loss of monocular vision, that comes on over minutes. The patient can usually count fingers.

The cause of this condition is a restriction of blood leaving the retina.

Risk factors include; atherosclerosis, diabetes, hypertension, hyperviscocity syndromes and glaucoma.

Examination should also include slit lamp examination and examination for pupillary response.

There is no acute treatment for the condition and a proportion of patients retain useful vision. Complications such as glaucoma need to be aggressively treated as they can obviously affect outcome.

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