Hollenhorst Plaques

What are Hollenhorst plaques?

Hollenhorst plaques are blockages in blood vessels in your retina. They can cause permanent damage to your eye, including blindness.

The retina is the layer at the very back of your eyeball. It converts light that enters your eye into electrical signals your optic nerve sends to your brain, which creates the images you see.

Plaque is a sticky substance made of fat, cholesterol, calcium and other substances. As plaque builds up, your arteries become hard and narrow. Hollenhorst plaques are created if plaque from somewhere else in your body breaks free and blocks a blood vessel in your retina. They’re a form of retinal artery occlusion (eye stroke). They’ll typically only affect one of your eyes.

Hollenhorst plaques don’t usually have any symptoms, but they can sometimes cause you to lose vision in one eye suddenly.

Because they develop over time and don’t usually cause symptoms you’ll notice, it’s hard to know you have a Hollenhorst plaque in your retina until it damages your eye. The best way to prevent them is to make sure you have healthy blood pressure and cholesterol levels.

Visit your healthcare provider or eye care specialist right away if you notice any changes in your eyes or vision. Go to the emergency room if you suddenly lose sight in one of your eyes.

How common are Hollenhorst plaques?

Hollenhorst plaques make up more than 80% of all retinal blockages.

However, retinal blockages themselves are rare. Less than 2% of people older than 49 ever develop a blockage in their retina.

What are the symptoms of a Hollenhorst plaque?

Most Hollenhorst plaques don’t cause any symptoms.

Unlike other conditions that make your vision get worse over time, if you do have symptoms, Hollenhorst plaques will cause sudden changes in your vision. One eye might totally lose sight or suddenly get blurry. That’s a result of the plague blocking blood flow to your retina.

Hollenhorst plaques don’t cause eye pain.

What causes Hollenhorst plaques?

Hollenhorst plaques form when a piece of plaque from somewhere else in your body travels through your blood vessels and gets stuck in your retina. They’re usually caused by carotid artery disease (carotid artery stenosis).

Carotid artery stenosis is a condition that happens when your carotid artery, the large artery on either side of your neck, becomes blocked. The blockage is made up of plaque. When plaque blocks the normal flow of blood through your carotid artery, you’re at a higher risk of stroke. It’s a form of atherosclerosis — hardening of your arteries caused by gradual plaque buildup.

Hollenhorst plaque risk factors?

Anyone can develop a Hollenhorst plaque. Men and people assigned male at birth are more like to develop them. People with certain health conditions are more likely to develop Hollenhorst plaques, including:

• High cholesterol (hyperlipidemia).
• High blood pressure (hypertension).
• Atherosclerosis.
• Diabetes.

How are Hollenhorst plaques diagnosed?

Your eye care specialist will diagnose a Hollenhorst plaque with an eye exam and imaging tests. They’ll look at your eyes (including inside them) and will perform a visual acuity test.

You might need one of a few types of imaging test too, including:

• Carotid ultrasound or a Doppler ultrasound.
• Angiography.
• MRI.

How are Hollenhorst plaques treated?

There usually isn’t any treatment you’ll need for a Hollenhorst plaque.

Some Hollenhorst plaques are discovered after they’ve damaged your retina. This damage is usually permanent.

How can I reduce my risk of developing a Hollenhorst plaque?

The best way to prevent Hollenhorst plaques is to prevent conditions like atherosclerosis. Some steps you can take include:

• Eat a healthy diet low in saturated and trans fats, cholesterol, sodium (salt) and sugar.
• Exercise regularly.
• Maintain a healthy weight.
• Manage any health conditions, especially diabetes, high blood pressure and high cholesterol.
• Quit smoking.
• Visit your healthcare provider and eye care specialist regularly.

When should I have my eyes examined?

Having your eyes and vision checked regularly can help your eye care specialist identify problems right away. How often you should get your eyes checked usually depends on your age:

• Adults under 40: Every five to 10 years.
• Adults between 40 and 54: Every two to four years.
• Adults older than 55: Every one to three years.

You might need your eyes checked more often than this if you wear glasses, contacts or need another type of visual aid. People with diabetes need their eyes checked more often than what’s listed here.

Ask your eye care specialist how often you need an eye exam.

What can I expect if I have a Hollenhorst plaque?

Hollenhorst plaques can cause permanent damage to your retina. Some people lose sight in their affected eye for the rest of their life, others have low vision.

You’ll need regular eye exams to monitor any changes in your eyes or vision.

People with Hollenhorst plaques have an increased risk of experiencing a stroke. Talk to your provider about how you can reduce your risk and warning signs to watch out for.

How your eye and vision are affected depend on what caused the Hollenhorst plaque and any other issues or conditions you have. Talk to your provider or ophthalmologist about what to expect.

When should I see my healthcare provider?

See your healthcare provider as soon as you notice any changes in your eyes or vision.

Go to the emergency room if you have any of the following symptoms:

• A sudden loss of vision.
• Severe eye pain.
• You see new flashes or floaters in your eyes.

What questions should I ask my doctor?

• Will I have permanent vision loss in my eye?
• How often will I need follow-up eye exams?
• Do I have carotid artery disease?
• What can I do to lower my risk for a stroke?

A note from Cleveland Clinic

Hollenhorst plaques can cause permanent damage to your vision before you know even have one. The best way to prevent them is to follow a healthy diet and exercise plan and see your healthcare provider regularly. They’ll be able to spot warning signs like high cholesterol or high blood pressure before they cause problems like Hollenhorst plaques.

Visit your eye care specialist for regular eye exams, too. Even small changes in your vision can be the first sign of a larger issue.