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How to manage central retinal vein occlusion?

Q: My mother who is 60 years old had a burst blood vessel in the eye for which she took laser treatment about 2 months back. The retina specialist assured her that her vision would improve in the affected eye. However her vision in that eye has not improved and she sees objects curved and reduced in size. When she consulted another eye specialist he told her that she had some macular oedema/macular puckering for which she required further investigation and treatment which could also be a repeat laser treatment. My mother does not have diabetes which is a possible risk factor for such a problem. She does however have mild hypertension and is prone to frequent attacks of migraine for which she is under medication. One eye doctor felt that certain migraine drugs like Cloton (Tolfenamic acid) could cause spasms in the blood vessel which may have resulted in the haemorrhage in the eye. Please let me know what should be the next course of action?

A:From your description it appears that your mother has had a central retinal vein occlusion (CRVO). People with hypertension are more prone to developing CRVO. Visual recovery is usually only partial in these cases. Some patients can also develop a type of glaucoma, which can be difficult to manage. A surgery called optical neurotomy is also being evaluated for this condition. She needs to be under the regular observation and care of a retina specialist and you have to be patient and accept the fact that visual recovery may be very limited.


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