Blinded by occlusion: transforming painless vision loss assessment in the ED

Painless vision loss presents a diagnostic conundrum for Emergency Medicine physicians, encompassing a spectrum of differential diagnoses ranging from benign to potentially serious conditions. Among these, Central Retinal Artery Occlusion (CRAO) stands out as a critical diagnosis requiring prompt recognition and intervention. In the Emergency Department, identifying CRAO poses a unique challenge due to its reliance on a fundoscopic examination, a procedure that may not be routinely performed by emergency physicians. This case series highlights the utility of Point-of-Care Ultrasound in aiding the rapid bedside identification of CRAO by recognizing the retrobulbar spot sign (RBSS). Our findings underscore the importance of integrating ultrasound into the armamentarium of emergency physicians for expeditious recognition and management of ophthalmologic emergencies such as CRAO.