Risk of further embolic events can be prevented through anticoagulation
Address vascular risk factors
Smoking status
Alcohol
Diet
Exercise
Blood pressure
Diabetes
Referral, depending on local guidelines: to acute stroke service, ophthalmology or in line with locally agreed referral pathway guidance.
Speed of referral depends on duration of symptoms
If chance finding then further investigation is not urgent
Send referral with visual fields to ophthalmology
Explain patient may be referred direct to CT head scan, but to await advice.
Management Category
Referral to GP
Referral, depending on local guidelines: to acute stroke service, ophthalmology or in line with locally agreed referral pathway guidance.
Possible management by Ophthalmologist
Exclusion of atrial fibrillation
If acute, or in the young, specialist vascular evaluation by stroke team
Neuroimaging
Advice on risk reduction
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The eyes.nhs.scot website (“Website”) is intended as a reference source for education and clinical
decision support and is intended for use by ophthalmic healthcare professionals.
The Website is not intended for use by the general public and does not replace the advice of a healthcare professional.
Members of the public should seek advice directly from their optometrist.
The guidelines on the Website were originally adapted from The College of Optometrists’ Clinical Management Guidelines
(CMGs), to incorporate pragmatic experience gained from NHS Grampian’s Eye Health Network. However, this content is currently under review.
The most up-to-date versions of The College of Optometrists’ CMGs can be accessed
at https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines.
The information on the Website provides guidance and related information for the differential diagnosis, possible
management by optometrists (treatment and advice), management category and possible management by ophthalmologists.
Users should note that that the guidance on the Website will not be suitable for every situation and is not intended to be a
substitute for specialist expertise and clinical judgement. Users should also note that this guidance should not be adhered to
in isolation and should be considered in conjunction with other national and locally available guidance/pathways.
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the Website is provided ‘as is’ and NSS does not warrant the accuracy and completeness of the material on the Website. NSS may
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