Classic - Central retinal vein occlusion

This was the case which I encountered last month. A 58-year-old female came with the chief complaint of sudden diminution of vision in her right eye for 3 days. She was already a known case of hypertension for which she was very reluctant to take medications.Based on the history of unilateral sudden painless vision loss and her being a hypertensive patient, I thought of retinal vascular occlusive pathology. When I examined her fundus with an indirect ophthalmoscope, there was this beautiful classical splash tomato appearance in her right eye. Her left eye was not affected at the time; however, there were mild age-related macular changes in her left eye.

After this I advised right eye OCT (5-liner) where you could see there was macular edema. Based on this, the best management is to go for an intravitreal anti-VEGF injection.

We called the patient after the injection, and after 1 month, the patient is feeling much better and this haemorrhages will take time to resolve but edema was reduced at that time and patient was advised to monitor blood pressure tightly.