Retinal vein occlusion (RVO) is a blockage in a small blood vessel that carries blood away from your retina. Symptoms include blurry vision or vision loss in one eye, which may develop suddenly. RVO can lead to serious complications like swelling or bleeding in your eye. Without treatment, these issues can lead to vision loss.
Retinal vein occlusion (RVO) is a partial or total blockage in a vein that drains blood from your retina. Your retina is a layer of tissue at the back of your eye that helps translate light into images you can see. A blockage in a retinal vein prevents blood from leaving your retina. This can lead to complications, including raised pressure in your eye and swelling. These issues need prompt treatment to prevent or minimize vision loss.
There’s no current safe way to unblock the vein. However, treatment can manage complications and protect your vision.
Eye care specialists tailor treatment to your individual needs. You may need multiple treatments ranging from injections to surgery to manage your condition.
There are two types of RVO:
Retinal vein occlusion is the second most common disorder affecting your retina (diabetes-related retinopathy is the most common).
Researchers estimate that globally:
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Symptoms of retinal vein occlusion typically affect one eye and include:
You may not have any symptoms until complications arise. Some people don’t realize there’s a problem until their provider finds the issue during a routine eye exam.
A disruption to normal blood flow through your retinal vein causes this condition. The disruption may happen due to:
Being over age 40 is a major risk factor. RVO usually affects people in their 50s or 60s. However, this condition can also affect people younger than age 40.
Having certain medical conditions can also raise your risk. These include:
Prior history of retinal vein occlusion in one eye raises your risk of developing the condition in your other eye.
Retinal vein occlusion can lead to complications such as:
People with RVO have a higher risk of cardiovascular diseases, including stroke, compared to people without RVO. This may be due to shared underlying risk factors like high blood pressure and atherosclerosis.
Your eye care specialist will dilate your pupils so they can see into the back of each eye. They’ll use a microscope and a head-mounted ophthalmoscope to shine a light into your eye. They’ll closely examine the inside of your eye to look for complications and signs of vision loss.
This exam can help:
You may need further testing to diagnose RVO and show the extent of complications.
Your eye care specialist may use one or more of the following tests to help diagnose and describe your condition:
Your eye care specialist and primary care physician will work together to find the cause of RVO and lower your risk for future issues. You may need blood tests to check your cholesterol levels, blood sugar and other important numbers.
There’s currently no way to reverse or cure the blockage in your retinal vein. But eye care specialists can prevent or treat the complications of retinal vein occlusion with:
The goals of treatment are to:
Your provider will combine treatment options as necessary and explain the timing for each.
This is a first-line (first-choice) treatment for people with macular edema. VEGF stands for vascular endothelial growth factor. This is a protein that spurs new blood vessel growth (angiogenesis). Too much VEGF can lead to the formation of abnormal blood vessels that can leak and cause swelling.
Anti-VEGF injections interrupt the production of VEGF in your eye to reduce swelling. Your provider gives you eye drops to numb your eye and reduce pain before injecting the medication into the gel-like substance (vitreous humor) that fills your eyeball. You may need injections at regular intervals for one to two years depending on your condition.
Specific medications you may receive in these injections include:
Injections of steroid medication into your eye can also help reduce swelling. However, in some people, steroid injections cause elevated eye pressure and cataracts. So, they’re often a second-line treatment when anti-VEGF injections aren’t adequate.
This laser surgery creates small burns in areas of your retina that lack blood flow. Doing so decreases the number of proteins (VEGF) that promote the formation of abnormal blood vessels. Reducing VEGF helps prevent neovascularization and related bleeding in your eye. It also helps keep your intraocular pressure stable.
Posterior pars plana vitrectomy (PPV) is a surgery that helps people with retinal vein occlusion who have:
Surgery removes vitreous humor from your eye and repairs damage to your retina.
Many people with retinal vein occlusion have underlying conditions like high blood pressure, diabetes or high cholesterol. These conditions can raise your risk of blood vessel problems. Your eye care specialist will work together with your primary care physician (PCP) to tailor treatment to your needs. Your PCP may prescribe medications to:
It’s also important to talk to your primary care physician about underlying conditions that raise your risk for blood flow problems. They’ll recommend treatments as needed to manage those conditions and help keep your eyes — and whole body — healthy.
Specific things you can do to lower your risk include:
Your prognosis depends on many factors, including the location of the blockage and complications that arise. Some people have permanent vision damage, while others have vision that gradually gets better over time. Your eye care specialist is the best person to tell you exactly what you can expect in your individual situation.
Your provider may refer you to vision rehabilitation. This is a form of rehab that teaches you techniques for living with reduced vision. These may include using devices like magnifying glasses or assistive-computer technology. Your provider may also refer you to a social worker who can help you cope with lifestyle changes.
Living with retinal vein occlusion (RVO) can be stressful because you may need:
All of this may take a toll and feel overwhelming to you. Remember that your healthcare team is there to help you.
Talk to your providers about how you’re feeling. They may suggest resources to help you learn more about your condition and why all of this effort is so important. They may also connect you with support groups or other community resources where you can talk to people who are in a similar situation. Learning from others’ experiences and sharing your own can help make everything feel more manageable.
Your eye care specialist will tell you how often you need appointments for monitoring or treatment. Call them if you experience new or changing symptoms or have questions about your treatment plan.
Call 911 or your local emergency number if you have symptoms of a retinal detachment. This is a medical emergency that requires prompt care.
You may want to ask your eye care specialist:
A note from Cleveland Clinic
It can be easy to forget that blood vessels play an important role in your vision. That’s because people often talk about veins and arteries that connect to your heart, brain or other large organs. But your retinal veins, though tiny, are just as important. A blockage can lead to serious issues with your vision and eye health. Plus, it may be a warning sign of blood flow problems throughout your body that need attention.
Keeping up with your eye health can help protect your vision, as well as the health of your entire body. Visit an eye care specialist regularly for exams. Tell them about any vision problems or symptoms you’re experiencing. Doing so can help identify problems like retinal vein occlusion (RVO) early so you can prevent or quickly treat complications.
Last reviewed by a Cleveland Clinic medical professional on 06/19/2023.
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