A 60-year old man came to our office with a chief complaint of sudden on-set of blurred vision that comes and goes in his right eye. There was no pain in his eye. During his comprehensive eye examination, a cholesterol plaque was found in one of the retinal arteries. See photo below:
Photo above shows a shiny-yellow reflective cholesterol plaque lodged in a retinal artery.
Patients with high blood pressure, high cholesterol, diabetes, and smoking are at greater risk of developing plaques. The most common site of plaque formation is in the carotid arteries found in the neck. The internal carotid artery is the major artery on each side of the head and neck that supplies blood to the eye and brain. A special test was called a carotid ultrasound was ordered to evaluate for plaque build-up and narrowing of the carotid arteries. Plaque build-up in the arteries can lead to a stroke. The carotid ultrasound showed a significant blockage of his right internal carotid artery due to plaque formation. This resulted in a piece of the plaque breaking off and traveling to the retinal artery in his right eye.
The patient is being managed by a local cardiologist and will need surgery to remove the plaque from his right internal carotid artery to prevent a stroke. He will most likely need to be on medication to prevent further plaque formation. Patients who experience a sudden onset of blurred vision, loss of vision or visual disturbances must be seen promptly by their eye care provider.