Fundoscopic Appearances Found in Sudden Visual Loss

Find out more about each of the fundoscopic appearances shown below.


Fig.10 Central retinal artery occlusion – image by Dr. Gopal Bisht, via Wikimedia Commons

Central retinal artery occlusion (CRAO) typically produces a very pale optic disc and retina, together with the classic ‘cherry red spot’ of the macula. This is due to the separate supply of the outer retina by the choriocapillaris.


Fig.11 Central retinal vein occlusion – image by Werner JU et al. via Wikimedia Commons

The appearance of central retinal vein occlsion (CRVO) is more dramatic; diffuse retinal haemorrhage and venous dilatation are seen in all four quadrants often referred to as a ‘blood and thunder’ or ‘stormy sky’ appearance.


In papillitis, fundoscopic changes are only seen with direct involvement of the optic nerve head resulting in a papillitis, visible as hyperaemia, blurred disc margins and occasionally haemorrhages.

This occurs in approximately one third of cases of optic neuritis, [12] the remainder causing a retrobulbar neuritis and a fundoscopically normal optic disc. Ischaemic optic neuropathy may also cause this appearance.

Retinal detachment

Fig.12 Retinal detachment via LITFL

Retinal detachment may be difficult to visualise as it often originates peripherally.

Minimal changes are usually seen with posterior vitreous detachment, but can include vitreous, retinal and optic nerve head haemorrhages. [13] Oedema of the optic nerve head and macula are also possible.