If one eye suddenly goes dark like a curtain being pulled down, treat it as a stroke and go to the emergency room the same day, even if it clears up in a few minutes
- High value
- Evidence B
- Buys life
- Free
- Takes some hours
- No willpower
In a real emergency, call 911 first, then read this.
In plain words
If one eye suddenly goes dark like a curtain being pulled down, a blood vessel at the back of the eye is blocked, and the longer it stays blocked, the less of the retina can be saved. It is also a kind of brain ischemia, and a stroke is likely over the next few days. Among people who were evaluated and started treatment the same day, the share having another stroke within 90 days fell from 10.3% to 2.1%. Go the same day to an emergency room with a stroke center, and don't wait until the next day to see an eye doctor.
- Cost
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Free. The emergency evaluation and vessel tests take half a day to a day.
- What you get
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The American Heart Association's 2021 scientific statement on central retinal artery occlusion (the main vessel at the back of the eye being blocked) says: "acute central retinal artery occlusion is an emergency." The care system should recognize it as an emergency and set priorities accordingly. The longer the blood supply is cut, the less retina can still be saved. The Oxford EXPRESS study looked at two kinds of patients: minor stroke, and brain ischemia whose symptoms clear up on their own (medically called transient ischemic attack). After these patients were switched to same-day evaluation and same-day start of treatment, the share having another stroke within 90 days fell from 10.3% (32/310) to 2.1% (6/281)
- Notes
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Graded B because EXPRESS was not a randomized trial. It compared the same population before and after a change in practice, and other conditions may also have changed between the two periods, which can't be separated out. A sudden blackout in the eye that recovers in a few minutes is most easily dismissed as "tiredness" or "low blood sugar." It is a kind of transient ischemic attack, and the next few days are exactly when strokes are most likely. Loss of sight in one eye without pain, redness or tearing should be taken especially seriously. Don't wait for the eye clinic the next day. Go straight to the emergency room of a hospital with a stroke center.
- Evidence grade
- B : Supported by research but without a precise number, or based on small or single studies.
- Sources
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- Mac Grory B, Schrag M, Biousse V, et al. (2021). Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association. Stroke, 52(6), e282-e294. https://doi.org/10.1161/STR.0000000000000366
- Rothwell PM, Giles MF, Chandratheva A, et al. (2007). Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet, 370(9596), 1432-1442. https://doi.org/10.1016/S0140-6736(07)61448-2
Mentioned in
Translated from the Chinese original. Original book, section 13, tip 5. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer