Is your eye experiencing reduced blood flow? Let's learn about this (Ocular Ischemic Syndrome)!

Have you suddenly lost your eyesight, or are you experiencing a strange, inexplicable pain or heaviness in one or both eyes? Or do your eyes turn blue when you go outside? Sometimes we think these are just eye strain, but there may be something more serious behind it. That's what Ocular Ischemic Syndrome is. Although the name may sound a little scary, let's talk about it simply.

What is this `(Ocular Ischemic Syndrome)`?

Simply put, Ocular Ischemic Syndrome is a rare eye condition that occurs when our eyes do not receive enough blood. This is mainly caused by fatty deposits (also called plaques) in the large blood vessels in our neck called the Carotid Artery. These blood vessels also supply blood to our eyes. So, when these blood vessels become blocked, the amount of blood going to the eyes decreases. This can cause vision problems and eye pain.

In other words, the meaning of this name, word for word, is as follows:

• "Ocular" means medically "pertaining to the eyes."
• "Ischemic" or "Ischemia" is a condition where blood flow is reduced due to "atherosclerosis" (thinning or hardening of the arteries). This condition is what causes "Carotid Artery Disease" (Carotid Artery Disease).
• "Syndrome" refers to a condition in which several symptoms occur together.

So, all of these put together, this is a collection of symptoms that are caused by reduced blood flow to the eyes. This condition, in particular, can be an early sign of `(Carotid Artery Disease)`. This condition called `(Carotid Artery Disease)` increases the risk of stroke and heart attack . Therefore, it is very important to be aware of this.

Why does this happen? What are the causes of `(Ocular Ischemic Syndrome)`?

As I said before, the main cause of this is `(Carotid Artery Disease)` (Carotid Artery Disease) . This is also called `(Carotid Artery Stenosis)`. `(Stenosis)` means narrowing or blockage of an artery. These two blood vessels called `(Carotid Arteries)` on either side of your neck carry oxygen-rich blood to your head, neck, brain, and eyes. So when `(Plaque)`, an oily substance, starts to build up inside these blood vessels (this is also called `(Atheroma)`), the blood flow becomes blocked.

The blood vessels called `(Ophthalmic Arteries)` that supply blood to our eyes start from these `(Carotid Arteries)`. So, a person with `(Carotid Artery Disease)` does not get enough blood to their eyes. That lack of blood is the basis for `(Ocular Ischemic Syndrome)`.

In addition to this main reason, there are other reasons that are seen very rarely:

• `(Carotid Artery Dissection)` (a condition similar to a carotid artery dissection)
• Vasculitis (inflammation of the blood vessels). Examples include Takayasu's Arteritis, Giant Cell Arteritis (GCA), and Behcet's Disease.
• `(Fibrovascular Dysplasia)`
• `(Scleroderma)`
• `(Moyamoya Disease)`

Who is most at risk?

Ocular Ischemic Syndrome is a very rare condition , affecting about 8 people per million.

This condition usually affects people between the ages of 50 and 80. Men are about twice as likely to develop it as women .

There are several risk factors that affect this:

• `(Cardiovascular Disease)` (Diseases of the cardiovascular system, that is, diseases related to the heart and blood vessels)
• Coronary Artery Disease (CAD)
• Diabetes
• High blood pressure (Hypertension)
• Being obese, smoking, or both.
• `(Moyamoya Disease)` (This is also a disease related to the blood vessels that supply blood to the brain)
• If you have previously had a stroke or a transient ischemic attack (TIA) (like a mini-stroke).

What are the symptoms of Ocular Ischemic Syndrome?

Symptoms of this condition don't always appear. But when symptoms do appear, they often only affect one eye . This condition mainly affects your vision. Look for these symptoms if you have any:

• A dull, aching pain that comes from inside the eye and comes and goes from time to time.
• Eye pain is felt when eye pressure increases.
• Dilated pupils (black circle in the middle of the eye).
• Feeling like black spots or threads floating before the eyes (Eye Floaters).
• Gradual or sudden loss of vision (Low Vision) or temporary loss of vision and then regaining it (Transient Vision Loss).
• Difficulty looking at light, blurred vision (Photophobia).
• Feeling like you are seeing two things (Diplopia).

How do doctors figure this out exactly?

The symptoms of Ocular Ischemic Syndrome can be similar to other conditions such as diabetic retinopathy and Central Retinal Vein Occlusion (CRVO). Therefore, it is important to get an accurate diagnosis .

Ophthalmologists perform the following tests to diagnose this condition:

• Eye examination: Various eye tests are performed to find the cause of vision problems. For example, a dilated eye exam, an optical coherence tomography (OCT) scan, an electroretinography (a test that measures the activity of the retina), and visual-evoked potentials (a test that measures the activity of the nervous system related to vision).
• Fluorescein Angiogram : This is a test in which a special dye is injected into a vein in the arm to check how long it takes for blood to flow through the blood vessels inside the eye and whether blood is leaking from the blood vessels.

In addition, a cardiologist (a doctor who specializes in heart and blood vessel diseases) may order tests such as these to check for carotid artery disease:

• `(Carotid Artery Duplex Vascular Ultrasound)` (A scan of the blood vessels in the neck)
• `(CT Angiogram - CTA)`, `(Carotid Angiogram)` or `(Magnetic Resonance Angiogram - MRA)` (these are also specialized types of scans that look at the condition of the blood vessels in the neck).

What are the treatments for this?

There are several interrelated steps involved in treating Ocular Ischemic Syndrome. This requires the cooperation of various specialists.

Treatment for eye problems:

• Types of eye injections: Anti-VEGF drugs or steroids. These help reduce swelling in the retina.
• Medicated Eye Drops: Reduce intraocular pressure and inflammation.
• It may also be necessary to undergo laser eye treatment to prevent high eye pressure.

Treatment for `(Carotid Artery Disease)`:

• Blood thinners, as well as medications to control conditions such as diabetes and high blood pressure.
• Carotid Angioplasty and Stenting: A procedure in which a blocked blood vessel is inflated with a balloon-like device and a stent (a small mesh-like tube) is inserted to prevent it from becoming blocked again.
• Carotid Endarterectomy: A surgical procedure to remove plaque that has built up inside a blood vessel.

What complications can this cause?

Not everyone with Ocular Ischemic Syndrome will develop serious vision problems right away. However, about half of people with the condition will experience some degree of vision loss within a year . Also, about seven out of ten people will develop a condition called Neovascular Glaucoma. In Neovascular Glaucoma, new, abnormal blood vessels form in the eye, blocking the flow of fluid inside the eye. This can cause dangerously high eye pressure.

What is the health status of someone with Ocular Ischemic Syndrome?

In fact, the condition called `(Carotid Artery Disease)` that causes `(Ocular Ischemic Syndrome)` can be life-threatening . After being diagnosed with `(Ocular Ischemic Syndrome)`, within five yearsNearly four out of ten people die from a heart attack or stroke. Therefore, seeking medical attention early and making lifestyle changes can go a long way in protecting your health.

Important: I'm not trying to scare you with this. But it's very important to understand the seriousness of this situation and take the necessary steps.

Can Ocular Ischemic Syndrome be prevented?

Yes, there are things you can do to reduce your risk of developing `(Carotid Artery Disease)` and through it, `(Ocular Ischemic Syndrome).` These are:

• Eat a heart-healthy diet, such as the Mediterranean Diet.
• Find healthy ways to manage stress.
• Control diabetes and high blood pressure well.
• Maintain a healthy weight that suits you.
• If you smoke, ask for help to quit.
• Stay as active as possible and exercise.

When should I see a doctor?

If you experience any of these symptoms, definitely see a doctor:

• Pain in the eyes.
• Any change in vision is a problem.

Also, if you experience symptoms of paralysis (e.g. difficulty speaking, numbness on one side of the body, drooping of one side of the face), go to a hospital immediately or call 1990.

What should I ask my doctor?

When you go to see the doctor, you can ask questions like:

• Why am I having these symptoms?
• What tests do I need to do?
• What treatment is best for me?
• What should I do to improve my heart health?
• What can I do to protect my eyesight?
• Should I be concerned about complications?

Any condition that affects the eyes is a real concern. If you have Ocular Ischemic Syndrome, vision changes could be the first sign that your blood vessels are blocked and blood flow to your head is reduced. This can also be a sign of other conditions, such as Carotid Artery Disease. Other eye conditions can also cause these symptoms.

Therefore, it is very important to see an ophthalmologist who has experience in diagnosing and treating such rare eye diseases . You may also need to see a cardiologist to treat ``Carotid Artery Disease''. This treatment works by opening a blocked blood vessel and improving blood flow to the eyes. You can also make lifestyle changes to protect your heart and eyesight.

The most important thing to remember (Take-Home Message)

• Ocular Ischemic Syndrome is a condition caused by decreased blood flow to the eyes, the main cause being blockage of the blood vessels in the neck (Carotid Arteries).
• If you have symptoms such as decreased vision or eye pain, be sure to seek medical advice.
• This could be a sign of ``Carotid Artery Disease'', which increases the risk of heart attack and stroke .
• With early detection, proper treatment, and lifestyle changes, health can be preserved.
• It is very important to avoid smoking, eat a healthy diet, exercise, and control diabetes and high blood pressure.

If you have any further questions about this, don't hesitate to talk to your doctor. Wishing you a speedy recovery!

` Ocular Ischemic Syndrome, Decreased blood flow to the eyes, Carotid Artery Disease, Decreased vision, Eye pain, Carotid Artery Disease, Atherosclerosis