Retinal Platelet-fibrin (Hollenhorst) Embolus
- Platelet-fibrin particle traveling from atheromatous cervical carotid bifurcation
- Named after Robert Hollenhorst, MD, who noted its connection to diseased carotid artery
- Usually causes transient vision loss as it first obstructs flow and then moves on distally
- May cause persistent vision loss from segmental retinal infarct
- Interpret this as sign of atheromatous cervical carotid disease
- Refer urgently to ophthalmologist for confirmation or to internist for vascular imaging
- Warning sign of unstable cervical carotid atheroma with potential for future stroke
- Greatest threat of future stroke is within days of ophthalmic event
