Retinal vein occlusion
Retinal vein occlusion (RVO) happens when a vein in the retina at the back of the eye gets blocked. The retina contains light-sensitive cells that are essential for vision. A retinal vein blockage can be caused by a blood clot and can happen in one of four branch veins (branch retinal vein occlusion, BRVO) or the main vein (central retinal vein occlusion, CRVO). It usually happens in one eye, is painless, and causes blurred vision or loss of vision.
It's not possible to treat or remove the blockage itself, but complications that develop, such as swelling in the macula, can be treated to limit further loss of vision. You can also manage risk factors for retinal vein occlusion, such as high blood pressure, high cholesterol, and diabetes.
Retinal vein occlusion symptoms
Retinal vein occlusion typically happens in one eye, causing reduced vision in the affected eye. You might experience blurred vision, a blind spot in your central vision, or loss of vision. The symptoms can develop quickly. It isn't normally painful unless you have complications like abnormal new blood vessels leading to glaucoma.
Most people with retinal vein occlusion will experience some lasting sight loss. The severity depends on exactly where the blockage happens, how severe the blockage is, and whether you experience complications.
Retinal vein occlusion treatment
Treatment for retinal vein occlusion can't remove the blockage or reverse damage caused by restricted blood flow, although laser treatment may be helpful in branch retinal vein occlusion.
Healthcare typically aims to prevent further loss of vision from complications and manage the risk factors that can contribute to it happening in the other eye.
If you develop macular oedema, treatment options include:
- Injections into the eye (intravitreal injections) with anti-vascular endothelial growth factor (anti-VEGF) medicine. Examples of these medicines include Eylea (aflibercept), Lucentis (ranibizumab) and Avastin (bevacizumab). These are given monthly at first, then at longer intervals. Treatment can last up to four years and prevent further central vision loss in nine out of 10 people (Source: Patient).
- Steroid implant injected into the eye every four to six months for up to four years. Around half of patients see a significant improvement with this treatment (Source: Moorfields).
If abnormal new blood vessels grow in the retina, you may have laser treatment. Pan retinal photocoagulation (PRP) can help prevent further damage to the retina. This treatment has the best chance of success if it happens before the new blood vessels leak and cause further vision loss.
Everyone with retinal vein occlusion will need regular follow-up appointments with their ophthalmologist to detect any complications which may need treatment. All treatments come with potential risks and side effects, and the right decision for you will depend on your diagnosis and circumstances. Your ophthalmologist will discuss the pros and cons of treatments with you, including the option to have your condition monitored rather than treated.
Retinal vein occlusion causes
Retinal vein occlusion happens when a blockage of the veins that drain blood from the retina obstructs the blood flow. The exact cause of the blockage can vary from blood clots to a fatty deposit in the wall of an artery in people with atherosclerosis (hardening of the arteries) to an inflammatory condition. As blood collects behind the blockage in the vein, fluid and blood can leak into the retina, preventing it from working correctly.
Risk factors that can increase the chance of getting retinal vein occlusion include:
- Age, with the condition being more common in people over the age of 60 (Source: RCOPHTH).
- High blood pressure (hypertension). Around 70% of people with retinal vein occlusion have high blood pressure (Source: Patient).
- Atherosclerosis. Hardening of the arteries can cause retinal arteries to narrow, pressing on the veins and making blockage more likely.
- High cholesterol that can lead to fatty deposits in retinal arteries.
- Glaucoma (high pressure in the eye).
- Diabetes, particularly if blood sugar levels aren't well managed.
- Smoking because it can increase the chance of blood clots.
- Blood clotting problems.
Living with retinal vein occlusion
It's natural to worry if you're diagnosed with retinal vein occlusion. You may be dealing with a new vision impairment and a long period of treatment and follow-up appointments. Your healthcare team will support you and can refer you to services such as a low vision assessment if you need them. Emotional support can be just as important as practical help. You could talk to family and friends about how you're feeling, or you may want to speak to other people with experience living with retinal vein occlusion. We can connect you with others and provide a range of support, to help you live the life you choose.
Frequently asked questions
Medically reviewed by: The Royal College of Ophthalmologists on 18/10/2022
Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.