Central Retinal Artery Occlusion (CRAO) And Hyperbaric Oxygen Therapy

What is CRAO? Central retinal artery occlusive disease (CRAO) is one of the most sudden and dramatic events seen in ophthalmology, though a less frequent chronic form also exists. It remains a disease of poor visual prognosis despite a multitude of studies and experimental trials. LEARN MORE ABOUT CRAO HERE.

In 2009 Anthem Blue Cross of California has added the indication of Central Retinal Artery Occlusion (CRAO) under the “Medically Necessary” list of treatable indications with HBOT. HERE IS THE MEDICAL POLICY.  If you or your center are interested in treating CRAO with HBOT I would encourage you to check into the following;
1. What are the common insurance companies in your area?
2. Search for the medical policies of these insurance companies to see if CRAO is on the covered list of indications.
3. Approach Opthamologists in your area and make them aware that patients with CRAO (when treated immediately) can be helped with HBOT.
4. Notify Emergency Rooms around you (if you are already at a hospital, have your medical director speak to the physicians at the ED/ER).
5. Some patients will offer to pay a cash rate especially if their insurance company does not cover HBOT for CRAO. So it is best to set up a cash rate for these patients by discussing with the business office of the hospital or upper management. In one hyperbaric center located at a hospital they charged the patient Medicare rates $90.00 per 1/2 hour of HBOT.

A CASE STUDY: I was fortunate enough to work with an Opthamologist that has also been trained in Hyperbaric Medicine. We recently treated an 84 y/o patient who lost total vision in his right eye and within 24 hours the patient was in the chamber. Within 5 minutes of being at depth (2.8 ATA) the patient started to gain some vision back in the affected eye. After the first HBO treatment the patient was able to read the Snellen chart at 20/200 (E), after treatment #5 the patient was able to read at 20/70 (TOZ), after 10 HBO treatments the patient was able to read at 20/30 (EDFCZP).

This is an excellent case study of HBOT and CRAO – if treated immediately can prevent the patient from permanent blindness.


4 thoughts on “Central Retinal Artery Occlusion (CRAO) And Hyperbaric Oxygen Therapy

    • I have seen a patient who waited 7 days after the occlusion happened and 5 hyperbaric treatments did nothing for him. I assume that hyperbaric treatments need to be initiated early (first 24 to 48 hours).

  1. I kinda’ figured that would be the case but I heard about this procedure this morning so I thought I’d write and give it a shot. (One hopes against all hope.) Thanks you very much for your quick response.

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