Retinal Vein Occlusion Treatment in Jacksonville, Florida
A retinal vein occlusion is a blocked vein in the retina — a stroke in the circulation of the eye. Blood and fluid back up behind the blockage, and vision drops, often overnight. It is treatable, and it is also a signal about your blood pressure and your cardiovascular health that should not be ignored.
Two kinds, and the difference matters
Branch retinal vein occlusion (BRVO) blocks one of the smaller veins draining part of the retina. It is roughly four to five times more common than the central form. Vision loss depends on whether the affected area includes the macula.
Central retinal vein occlusion (CRVO) blocks the main vein draining the whole retina. Vision loss is usually more sudden and more severe.
CRVO is further divided into non-ischemic and ischemic. Roughly 20 to 25 percent are ischemic, meaning large areas of retina have lost their blood supply. Those eyes are at real risk of growing abnormal new vessels on the iris and developing neovascular glaucoma — a painful, sight-threatening pressure rise that typically appears in the first two to four months. That is why an eye with a CRVO is followed closely and monthly early on, with the iris and the drainage angle examined, not just the retina.
Symptoms
- Sudden painless blurring or loss of vision in one eye, often noticed on waking
- A dark or missing area in part of the vision
- Distortion of straight lines
- New floaters, if there has been bleeding into the vitreous
Pain is not typical at the outset. Pain appearing weeks later, with redness and a very blurred eye, suggests neovascular glaucoma and is an emergency.
Why it happened — and why we care about the rest of you
A retinal vein occlusion is rarely just an eye problem. High blood pressure is the single strongest risk factor, roughly tripling the risk, and something on the order of two thirds to three quarters of patients with a vein occlusion have it — often undiagnosed or under-treated. Also implicated: high cholesterol, glaucoma or raised eye pressure, and, for central occlusions specifically, diabetes. Diabetes is associated with central but not branch occlusions, a distinction that gets blurred on a lot of websites.
Dr. Elkeeb is board certified in Internal Medicine as well as Ophthalmology. In practice that means the visit that diagnoses your vein occlusion also asks what your blood pressure has been doing, whether your lipids have been checked, and whether your primary care physician knows. Every patient with a vein occlusion should have blood pressure, lipids, and glucose reviewed. That is the workup with the highest yield, and it is the one most often skipped.
When we look for a clotting disorder
Testing for inherited or acquired clotting disorders is not routine — the yield is low and a positive result rarely changes what we do for the eye. We reserve it for patients where it is likely to matter:
- Both eyes affected
- Younger patients — under about 50
- A personal or family history of blood clots, particularly clots before age 50
- Recurrent occlusions
How we examine and image the eye
Diagnosis is made on dilated examination and confirmed with imaging performed in our office at the same visit:
- Optical coherence tomography (OCT) — measures macular swelling in microns and is what we use to decide when to treat and when to extend
- OCT angiography — shows areas where capillaries have closed off, without dye
- Fluorescein angiography — maps non-perfused retina and is how ischemic disease is confirmed
- Ultra-widefield fundus photography — documents the extent of haemorrhage and gives a baseline
More about our imaging and diagnostic testing.
How we treat it
Anti-VEGF injections — the mainstay
Most vision loss in vein occlusion comes from macular edema, and anti-VEGF injections are the primary treatment for it. The trial results are among the most convincing in retina: in BRVO, treated eyes gained roughly 18 letters at six months against 7 with sham; in CRVO, roughly 15 letters against essentially none.
We use aflibercept (Eylea and Eylea HD), bevacizumab (Avastin), faricimab (Vabysmo), and approved biosimilars. Faricimab was approved for vein occlusion in 2023 and aflibercept 8 mg in November 2025, so the choice is wider than it was even two years ago. Which agent we start with depends in part on your insurance, and we will tell you plainly what that means for you.
Worth knowing: the SCORE2 trial found aflibercept and bevacizumab produced comparable vision gains in central vein occlusion. Starting on the less expensive agent is an evidence-based choice, not a compromise.
Steroid treatment
For eyes whose swelling does not respond adequately to anti-VEGF, a corticosteroid delivered into the eye often works where injections have not. We use the dexamethasone implant (Ozurdex), the fluocinolone acetonide implants (Iluvien and Retisert), and triamcinolone. Steroids in the eye raise the risk of cataract and of elevated eye pressure, so this is a deliberate step with close follow-up rather than a default.
Laser
Two different lasers do two different jobs here.
Grid laser to the macula has a role in branch vein occlusion with mild macular edema. It is not a substitute for injections in eyes with significant swelling, but it remains useful in the right eye.
Ablative scatter laser treats the oxygen-starved retina in ischemic disease, removing the drive for abnormal new vessel growth and protecting against neovascular glaucoma. Note that this is treatment for neovascularisation that has appeared or is imminent — the Central Vein Occlusion Study found no benefit in applying scatter laser pre-emptively to every ischemic eye, so we treat when there is something to treat and watch closely in between.
What to expect
Vision often improves substantially with treatment, and the improvement usually begins within the first few injections. But a vein occlusion leaves the retina altered, and how much vision returns depends heavily on how much of the macular circulation was damaged at the outset — something we can see on angiography and cannot change.
Treatment is also usually not a short course. Many patients need injections over a year or more, with the interval extending as the retina dries. Some need ongoing treatment. The interval is set by the OCT scan, not by a schedule.
When to call us urgently
- A sudden drop in vision in one eye
- Pain or redness in an eye with a known vein occlusion
- A sudden shower of new floaters
- A shadow or curtain across the vision
Questions patients ask
Will my vision come back?
Often a good deal of it does, particularly with prompt treatment of the swelling. How much depends on how much of the macular blood supply survived the occlusion. We will be able to tell you more once we have your angiogram than we can from your vision alone.
Is a retinal vein occlusion a stroke?
It is a clot in a vein of the eye, so the mechanism has something in common with a stroke, but it is not a stroke of the brain. It does, however, share risk factors with cardiovascular disease, which is why the systemic workup matters.
Will the other eye be affected?
Most people have only one eye affected, but the risk in the fellow eye is higher than average — around 5 to 10 percent of branch occlusions are bilateral. Controlling blood pressure is the most useful thing you can do about that.
Can I stop my blood thinner, or should I start one?
Do not change any medication based on this page. Aspirin and anticoagulants have not been shown to treat retinal vein occlusion, and whether you should be on one is a decision for the physician managing your overall health. We are glad to be part of that conversation.
How long will I need injections?
There is no fixed answer. Many patients treat frequently for the first year and then extend as the macula dries. Some are able to stop. The OCT decides, not the calendar.
Getting seen
We accept urgent referrals and see urgent cases within 24 hours. Call (904) 666-5050. Our office is open 8:00 am to 5:00 pm, Monday to Friday, at 3627 University Blvd S, Suite 605, Jacksonville, FL 32216. Our staff speak English, Arabic, and French.
Dr. Elkeeb operates at HCA Florida Memorial Hospital and Baptist Medical Center Jacksonville.
Referring physicians and optometrists: our referral information is here.
Sources: EyeWiki, Branch Retinal Vein Occlusion and Central Retinal Vein Occlusion (American Academy of Ophthalmology); global epidemiology of retinal vein occlusion, systematic review and meta-analysis, 2019; BRAVO, CRUISE, VIBRANT, SCORE and SCORE2 trials; Central Vein Occlusion Study; FDA approvals of faricimab (October 2023) and aflibercept 8 mg (November 2025) for macular edema following retinal vein occlusion.
This page is general information about a medical condition and is not a substitute for examination and advice from your own physician. Do not start, stop, or change any medication based on what you read here.