What is the ophthalmic exam finding in a patient with central retinal artery occlusion (CRAO)?

In a patient with central retinal artery occlusion (CRAO), the classic finding during an ophthalmic examination is the presence of a cherry red spot on the fovea accompanied by retinal pallor. This occurs because the fovea, which is the central part of the retina responsible for sharp vision, appears red due to the underlying choroidal circulation being unaffected. In contrast, the surrounding retina experiences ischemia due to the occlusion of the central retinal artery, leading to a pale appearance.

This distinctive pattern is crucial for diagnosis because it visually confirms the underlying pathology of CRAO, distinguishing it from other retinal conditions. While hemorrhagic retinopathy, retinal detachment, and normal retinal appearances may feature in different ocular diseases, they do not describe the specific phenomena seen in CRAO, where the combination of retinal pallor and the cherry red spot is the hallmark diagnostic sign.