Testing for carotid atherosclerosis

Optometrists frequently examine patients with the signs and symptoms of carotid artery disease. Referral for appropriate testing is mandatory in such patients.

A review of the noninvasive tests which an optometrist can perform in the office is presented. The paper also describes the noninvasive tests which are performed in vascular clinics on patients in whom carotid atherosclerosis is to be ruled out. Arteriography, both conventional and digital subtraction studies, is also described.

A discussion of the appropriate medical and surgical treatment of patients with carotid atherosclerosis and the ocular manifestations of it is included in the paper.

With the increasing expansion of the scope of practice for optometrists, it is imperative that the signs and symptoms of carotid atherosclerosis be understood and managed appropriately. Preliminary tests for carotid arterial disease can be performed in the office, and referral for more extensive testing is better accomplished when those tests are understood by the referring optometrist.