Ophthalmic management, if seen within 48 hours of the occlusive event |
A Lie the patient flat |
Ocular massage |
Stat intravenous acetazolamide, 500 mg |
and/or |
Paracentesis |
Inhalation of carbogen |
or |
B Intraophthalmic artery fibrinolysis, followed by 2 to 3 days of intravenous heparinisation. This therapeutic option should only be considered in a clinical setting that offers appropriate neuroradiological support and expert supervision. |
Non-ophthalmic management |
Cessation of cigarette smoking |
Dietary advice in the presence of hypcholesterolaemia and hypertriglyceridaemia |
Management of any coexisting hypertension, diabetes mellitus or hyperlipidaemia |
Oral aspirin therapy |
Specialist referral in the presence of systemic vasculitis, significant carotid artery stenosis, |
Hypercoagulable states, valvular heart disease and complex arrythmias. |