Eye Stroke Care

Central Retinal Artery Occlusion, Branch Retinal Artery Occlusion

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Eye strokes are vastly underrecognized and undertreated. Duke’s unique eye stroke care team brings together experts in emergency medicine, neurology, ophthalmology, hyperbaric medicine, and more. Together they work to quickly diagnose eye stroke, prevent permanent vision loss, and reduce your risk for a future stroke.


An eye stroke is a medical emergency that requires urgent attention. If you or a loved one are experiencing sudden, painless vision change or vision loss in one eye, seek immediate care.

About Eye Stroke

Similar to some strokes caused by blockages in blood vessels in the brain, an eye stroke is caused by a blockage, typically a blood clot, in an artery in the eye. 

A blockage in the main artery in the retina is called a central retinal artery occlusion (CRAO). A blockage in a smaller artery is called a branch retinal artery occlusion (BRAO).

Because these arteries are responsible for supplying blood to the eye, a lack of blood flow can affect your vision. Without quick intervention, you may experience permanent vision loss or blindness.

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Eye Stroke Symptoms

The hallmark signs of eye stroke are sudden and painless vision loss or changes in vision -- like blurriness, floaters, a darkened area in your field of vision, decreased visual contrast, and light sensitivity -- in one eye. Although these symptoms usually come on quickly, they can appear gradually.

Our Locations

Emergency eye stroke care is provided at our hospitals' emergency room locations in Durham and Raleigh. We offer follow-up eye stroke care at our innovative eye stroke clinic located within the Duke Eye Center in Durham.

Diagnosing Eye Stroke

To definitively diagnose an eye stroke, an ophthalmologist performs an eye exam in person or reviews a special picture called a fundus photo, which images the internal parts of your eye, including the optic nerve and retina. Diagnosis should be done as soon as possible in an emergency department. 

Emergency Eye Stroke Treatment

The faster you receive care for an eye stroke, the more likely you will experience positive outcomes. 

Tissue Plasminogen Activator (tPA)

To be safe and effective, this clot-busting medication must be administered intravenously within four-and-a-half hours of the onset of your eye stroke symptoms. If you cannot receive tPA through a vein, your doctor may recommend a minimally invasive catheterization procedure to administer tPA directly to the clot. Tissue plasminogen activator works to dissolve the blood clot that is clogging your retinal artery. It also carries a risk of bleeding. 

Hyperbaric Oxygen Therapy

This painless therapy uses large, pressurized chambers to deliver high levels of oxygen to your bloodstream. The increased oxygen helps preserve the retina’s energy supply and optimize your recovery.

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Follow-Up Eye Stroke Care

Assessing Stroke Risk and Coronary Artery Disease Risk 
An eye stroke can increase your risk of brain stroke, and vice versa. A vascular neurologist -- a neurologist who specializes in stroke care -- will evaluate your risk factors for a future stroke. Your doctor will consider your blood pressure, cholesterol levels, weight, diet, exercise habits, whether you have diabetes or arrhythmias, and your personal and family history, among other factors.

Imaging Tests
A vascular neurologist or cardiologist may also recommend that you undergo an ultrasound or other imaging to determine whether you have or are at risk for carotid artery disease or heart disease.

Eye Care
Optometrists, ophthalmologists, or retinal specialists can treat or help prevent complications like retinal disease that can affect your eyes and vision after an eye stroke. 

Low Vision Rehabilitation
If you experience permanent vision loss, our low vision rehabilitation specialists help you adjust to your condition. We recommend equipment and devices to make daily life easier. Our dedicated social worker will educate you and your loved ones to minimize the emotional impact of vision loss.

Why Choose Duke

Unparalleled Eye Care Expertise
Duke’s team includes some of the country’s most established and respected eye stroke experts. In fact, one of our vascular neurologists recently won an award from the American Heart Association / American Stroke Association for his breakthrough research studying eye stroke. Our ophthalmology program is nationally ranked and is the highest-ranked program in North Carolina. Duke’s hyperbaric chamber program is one of the country’s largest, and one of only a few in the Southeast that operate 24/7. We leverage these resources to ensure you receive top-notch care.

Comprehensive Approach to Eye Stroke Care
Duke’s care team is passionate about raising awareness about eye stroke and working together to ensure you receive the best possible care. Our ophthalmologists and neuro-ophthalmologists (eye doctors who specialize in treating vision problems related to the brain, like stroke) provide fast, advanced diagnostic services 24/7 either in-person in the emergency department or remotely. Emergency medicine doctors and vascular neurologists move quickly to administer time-sensitive treatment options. Retinal specialists, hyperbaric oxygen therapy experts, and other specialists are available throughout Duke Health to meet your immediate care needs and reduce your future stroke risk.

Regional Access to Duke
Duke’s Telestroke Network gives five NC and VA hospitals access to Duke stroke specialists 24/7. Our Life Flight helicopters and ambulances make it possible for you to quickly transfer to Duke for emergency eye stroke care.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 07/20/2023 by