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. 2025 Jun 25.
doi: 10.1007/s40477-025-01034-7. Online ahead of print.

Blinded by occlusion: transforming painless vision loss assessment in the ED

N Vuong  1   2 , E Richardson  1   2 , L Silva-Baucage  3   4 , F Zorrilla-Caballero  1 , A Icazatti  1 , D Lebowitz  1 , J Rosario  1   2
Affiliations

Blinded by occlusion: transforming painless vision loss assessment in the ED

N Vuong et al. J Ultrasound. .

Abstract

Painless vision loss presents a diagnostic conundrum for Emergency Medicine physicians, encompassing a spectrum of differential diagnoses ranging from benign to potentially serious conditions. Among these, Central Retinal Artery Occlusion (CRAO) stands out as a critical diagnosis requiring prompt recognition and intervention. In the Emergency Department, identifying CRAO poses a unique challenge due to its reliance on a fundoscopic examination, a procedure that may not be routinely performed by emergency physicians. This case series highlights the utility of Point-of-Care Ultrasound in aiding the rapid bedside identification of CRAO by recognizing the retrobulbar spot sign (RBSS). Our findings underscore the importance of integrating ultrasound into the armamentarium of emergency physicians for expeditious recognition and management of ophthalmologic emergencies such as CRAO.

Keywords: Central retinal artery occlusion; Ocular ultrasound; Painles vision loss; Retrobulbar spot sign.

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Conflict of interest statement

Declarations. Conflict of interest: The authors Vuong Nicole, Richardson Elliot, Silva-Baucage Lidalee, Zorrilla-Caballero Frank, Icazatti Amanda, Lebowitz David, and Rosario Javier declare that they have no conflicts of interest relevant to the content of this case report. Ethical approval: This case report was conducted in compliance with IRB and institutional guidelines. Written informed consent was obtained from the patient (or legal guardian) for publication of the case details and accompanying images. (24–5490).

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