Mount Sinai Health System has opened New York City's first eye stroke program to accelerate the diagnosis and treatment of patients who arrive in the emergency room with an eye stroke, a medical emergency that must be treated as soon as possible to avoid irreversible vision loss.
The Mount Sinai Health System's four emergency departments are now the only ones in New York City with modern high-resolution imaging technologies that can detect eye stroke quickly.
Patients can have an urgent procedure to maintain their vision within a few hours (or less) of arriving at the hospital, thanks to new communication and treatment protocols involving emergency medicine physicians, ophthalmologists, and the stroke department.
“Eye stroke is one of the most urgent eye conditions and there’s a small window of opportunity for treatment to prevent blindness. Mount Sinai is proud to offer this innovative service designed to ensure patients get immediate treatment to save their vision,” Richard B. Rosen, MD, Chief of the Retina Service for the Mount Sinai Health System, said in a news release.
“Patients need to know that if you wake up with vision loss in one eye, go to a Mount Sinai Health System emergency room immediately. Our ability to restore vision from an eye stroke is extremely time-sensitive. The day after is unfortunately too late. If the cause is something other than a stroke, we will send the patients to one of our ophthalmologists for appropriate care.”
Eye stroke, also known as central retinal artery occlusion, is characterized by sudden vision loss in one eye.
It occurs when a blood clot blocks the primary artery that delivers blood to the retina, depriving the retina of oxygen.
Unless blood flow is restored, the retinal nerve cells that allow you to see will die within hours.
The clot needs to be dissolved within 12 hours of losing vision (ideally 6 hours or less) or it will lead to permanent vision loss.
Mount Sinai's Department of Ophthalmology built optical coherence tomography (OCT) systems at The Mount Sinai Hospital, Mount Sinai West, and Mount Sinai Queens, all of which have major emergency rooms and stroke teams, to help speed up care.
This service is also available at Mount Sinai's New York Eye & Ear Infirmary (NYEE).
OCT technology, which was developed at NYEE, is a non-invasive method of detecting microscopic changes in the retina in minutes, allowing for quick diagnosis and therapy.
When a patient with a probable eye stroke comes to the emergency room, the neuroradiology team is urgently called to do an immediate scan.
They send the photos to an on-call retinal specialist, who can diagnose the problem right away.
If an eye stroke is confirmed, the patient is promptly sent to the Mount Sinai stroke team, where interventional neuroradiologists break the clot by injecting tissue plasminogen activator (tPA), a clot-dissolving medication, directly into the blocked ophthalmic artery.
If a patient with suspected eye stroke arrives at a Mount Sinai emergency department that does not have this service, they will be transferred to one of the hospitals that are equipped with OCT technology and treatment capability.
"Stroke to the eye, like a stroke to the brain, is a time-sensitive medical emergency. At the Mount Sinai Health System, our multidisciplinary teams use cutting-edge resources to deliver potentially vision-restoring care to these patients as quickly as possible," says Michael Fara, MD, PhD, Interim Director of the Comprehensive Stroke Center at The Mount Sinai Hospital.
The New York Eye and Ear Infirmary Research Foundation provided the support to bring OCT technology to the emergency rooms within the Mount Sinai Health System.