What treatment is recommended for acute central retinal artery occlusion?

For acute central retinal artery occlusion, the recommended treatment involves repeated pressure on the orbit for 10-15 seconds. This maneuver is meant to help dislodge the embolus causing the obstruction. The application of pressure potentially allows for the improvement of blood flow by creating a pressure gradient, which might encourage collateral circulation.

In cases of central retinal artery occlusion, time is critical, and the goal is to restore retinal perfusion as quickly as possible to prevent permanent vision loss. While other options might have some theoretical basis for treatment, they are not indicated as first-line immediate interventions in the acute setting. For instance, intraocular injection of steroids is not a standard treatment strategy for this condition; it is more commonly reserved for inflammatory conditions or certain types of macular edema. Immediate surgery to remove the embolus is generally not performed, as surgical intervention is not routinely indicated and is often not feasible in acute settings. Oral antibiotics do not have any role in the treatment of retinal artery occlusion since the condition is not caused by an infection but rather by a vascular occlusion. Thus, applying pressure to the eye is the appropriate response to this urgent situation.