For example, a sudden severe loss of vision can occur when there is intravitreal hemorrhage. Visual prognosis with proliferative retinopathy is more guarded if associated with severe retinal ischemia, extensive neovascularization, or extensive fibrous tissue formation. Treatment Control of the diabetes and BP is important. Visual symptoms, including blurred vision, sudden loss of vision in one or both eyes, and black spots or flashing lights in the field of vision, are indications for ophthalmologic referral at any time. Panretinal photocoagulation may diminish or eliminate proliferative retinopathy and neovascularization of the iris.
Early photocoagulation decreases the risk of neovascular glaucoma development.
Vitrectomy may be useful in cases of vitreous hemorrhage. Branch retinal artery occlusion is often caused by an embolus. The pupil may respond poorly to direct light but may constrict briskly when the other eye is illuminated. Typically, the arteries are attenuated and may even appear bloodless. If a major branch is occluded rather than the entire artery, fundus abnormalities are limited to that sector of the retina, and a permanent subtotal visual field loss follows unless the occlusion is relieved.