Sudden loss of vision is an ophthalmological emergency and requires immediate referral to the eye emergency department.
The cause should be ascertained. A high ESR is suggestive of an inflammatory cause such as giant cell arteritis.
A rapid reduction of the intraocular pressure may allow the circulation to be restored in embolic or thrombotic occlusion. This must be done within the first 2 hours, the principle being to dislodge the emboli into a more peripheral branch. Methods used include massage of the globe, paracentesis of the anterior chamber, or iv acetazolamide. A cardiovascular assessment is indicated to ascertain the source of the thrombus or embolus.
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