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November 1985

Oculopression in Detection of Occult Retinal Emboli

Author Affiliations

Washington, DC

Arch Ophthalmol. 1985;103(11):1627. doi:10.1001/archopht.1985.01050110021003

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To the Editor.  —Patients with visible retinal emboli had a significantly shorter survival span compared with a matched group of retinal strokes without demonstrable emboli.1 Increased detection of emboli entails early fundus examination after an episode of visual blackout (before dissolution or peripheral migration of the embolus) and repeated funduscopic examinations to increase the chance of finding a wandering embolus. Large occult emboli occur at the prelaminar side of the central retinal artery. Smaller occult emboli lodge in a branch artery, allowing enough blood flow to surround the embolus and therefore preventing its detection. Pressure applied to the globe during Goldmann contact lens examination decreases the blood flow to the eye and uncovers the embolus. A peculiar phenomenon was witnessed during a routine oculopression in an asymtomatic elderly patient. A yellowish embolus was apparent only after oculopression, falling down from the second to the first bifurcation and returning to

Savino PJ, Glaser JS, Cassady J:  Retinal stroke: Is the patient at risk? Arch Ophthalmol 1977;95:1185-1189.Article
Patrinely JR, Green WR, Randolph ME:  Retinal phlebitis with chorioretinal emboli . Am J Ophthalmol 1982;94:49-57.
Arruga J, Sanders MD:  Ophthalmologic findings in 70 patients with evidence of retinal embolism . Ophthalmology 1982;89:1336-1347.Article