Posterior Segment
Central Retinal Vein Occlusion
Also known as: CRVO, central retinal vein occlusion, retinal haemorrhages all quadrants, venous tortuosity, disc oedema with haemorrhages
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Obstruction of venous outflow at the central retinal vein, presenting with sudden or subacute painless blurring in one eye that ranges from mild to severe. Diffuse retinal haemorrhages, dilated tortuous retinal veins and disc swelling are the usual picture. Urgent retinal review assesses macular involvement and ischaemic complications, and the systemic vascular context warrants medical follow-up in its own right.
Recognition
Symptoms: what patients report
- Sudden or subacute blurred vision in one eye.
- Visual reduction can range from mild blur to severe loss.
- Usually painless.
Signs: what the examination shows
- Diffuse retinal haemorrhages.
- Dilated tortuous retinal veins.
- Disc oedema or optic disc swelling may be present.
- An RAPD, extensive haemorrhage and cotton wool spots are signs of ischaemic CRVO and of neovascular risk.
What OptoGuide™ covers for central retinal vein occlusion
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked New Zealand therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Central Retinal Vein Occlusion — EyeWiki
- Retinal vein occlusion — College of Optometrists CMG
- Retinal Vascular Occlusions. Scott IU, Campochiaro PA, Newman NJ, Biousse V. Lancet (London, England). 2020;396(10266):1927-1940.
- Retinal Vein Occlusions Preferred Practice Pattern®. Kovach JL, Bailey ST, Kim SJ, et al. Ophthalmology. 2025;132(4):P303-P343.
- Ocular Ischemic Syndrome - A Systematic Review. Terelak-Borys B, Skonieczna K, Grabska-Liberek I. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2012;18(8):RA138-144.
- Optometry Australia — A Diagnostic Guide to Posterior Eye Disease, Chairside Reference Pack (Centre for Eye Health), Version 2.0, 2026: Secondary Glaucomas
- Eye Emergency Manual, 3rd edition. NSW Agency for Clinical Innovation. December 2023.
- Retinal vein occlusion (RVO) guideline: executive summary. Nicholson L, Talks SJ, Amoaku W, et al. Eye. 2022;36(5):909-912.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.