• Interruption or segmentation of retinal venous columns and disappearance of the retinal arterial pattern, possibly the most nearly infallible clinical sign of death, was first described almost 100 years ago. Movement of venous segments has subsequently been advanced as an indication of reversibility of death. Direct cardiac massage or electrical defibrillation for cardiac standstill and ventricular fibrillation make the need for determining the absence of cardiac output and the prospects of uncomplicated resuscitability an urgent procedure, now that cardiac standstill is no longer invariably fatal. Absence of the described intraocular phenomena on ophthalmoscopy would signify a vital heartbeat, and thoracotomy would be ophthalmoscopically contraindicated.
Kevorkian J. RAPID AND ACCURATE OPHTHALMOSCOPIC DETERMINATION OF CIRCULATORY ARREST. JAMA. 1957;164(15):1660-1664. doi:10.1001/jama.1957.02980150028008