Abstract
<title>Abstract</title> <p>Background Central retinal artery occlusion is a rare but devastating complication of blunt ocular trauma, particularly in young patients without traditional vascular risk factors. Prompt recognition and treatment are critical, but therapeutic options remain limited and time-sensitive. We report this case to highlight the importance of immediate visual assessment in periocular trauma and to underscore the narrow therapeutic window for potential interventions. Case presentation A 28-year-old male presented to the emergency department with acute, painless vision loss in his left eye immediately after his eye struck a faucet during a fall. On examination, visual acuity was no light perception, with a relative afferent pupillary defect. Funduscopy revealed diffuse retinal edema, attenuated retinal arteries, and a cherry-red spot. Fluorescein angiography confirmed delayed arterial filling, and optical coherence tomography demonstrated acute inner retinal ischemia. Immediate conservative management was initiated, including ocular massage, carbogen inhalation, and pharmacologic interventions. At two-week follow-up, visual acuity remained no light perception. Conclusions This case demonstrates that central retinal artery occlusion can occur as a severe complication of blunt ocular trauma in young, otherwise healthy individuals. It emphasizes the need for prompt visual assessment in all patients with periocular trauma and early neurovascular consultation, as therapeutic windows for interventions such as intra-arterial thrombolysis are narrow and frequently limited by delayed presentation or resource availability.</p>