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CRAO — RACP Adult Medicine MCQ

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ModerateNeurologyCRAORACP Adult Medicine

A 45-year-old man presents with acute onset of painless monocular visual loss in the right eye. He describes a curtain descending over his vision. Fundoscopy shows a pale retina with a cherry-red spot at the macula. Right afferent pupillary defect is present. What is the most likely diagnosis?

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Correct answer: D — Central retinal artery occlusion

Sudden painless monocular visual loss with pale retina, cherry-red spot at macula, and RAPD is diagnostic of central retinal artery occlusion (CRAO). This is an ophthalmological emergency analogous to stroke. The cherry-red spot represents the choroidal circulation visible through the thin fovea while surrounding retina is ischaemic. Urgent stroke workup and management.

Reference: Stroke Foundation Australia – 2024 – CRAO as Stroke Equivalent