In the appropriate clinical context, a sickle cell preparation or urine drug screen could be helpful. Obtaining a chest radiograph for a complete initial evaluation is recommended. Focus other testing on specific ophthalmic evaluation. Visual acuity is mandatory in virtually all instances. Initially consider at least a gross evaluation of visual fields, central and peripheral.
Formal testing can follow at a later point.
In some cases, tonometry may be necessary. Anticoagulants, antiplatelet agents, fibrinolytics, and thrombolytics have no therapeutic value and may be harmful. Other therapies that have been used but found to be ineffective include surgical decompression, low molecular weight dextran, hemodilution, and carbon dioxide inhalation. Not all patients will respond. Patients with vasculitis may show marked improvement.