Ophthalmology · Fundus photograph

Cherry-Red Spot (Central Retinal Artery Occlusion)

A red fovea standing out against a pale, swollen retina — the cherry-red spot of central retinal artery occlusion (CRAO).

Fundus photograph with a pale whitish retina and a small bright red spot at the centre of the macula
Cherry-red spot at the fovea surrounded by opaque, ischaemic retina.Image: 18mlk7, via Wikimedia Commons — CC BY-SA 4.0.

Written & reviewed by: Kinase Medical Team · Last reviewed: 30 September 2026 · Editorial policy

Key features

  • Sudden, painless, monocular loss of vision, often severe; transient episodes may precede it.
  • Ischaemic retina turns pale and opaque; the thin fovea lets the intact choroidal circulation show through as a red spot.
  • Retinal arteries look thin and bloodless.
  • Causes: thromboembolism from the carotid arteries or heart; inflammatory causes such as giant cell arteritis.
  • Treated as a 'stroke of the eye' — urgent evaluation for cerebral ischaemia and an embolic source.

Differential diagnosis

Differential diagnosis of Cherry-Red Spot (Central Retinal Artery Occlusion)
ConditionHow to tell it apart
Sphingolipidoses / mucolipidoses (e.g. Tay-Sachs disease)Cherry-red spot from storage material in the retinal ganglion cell layer — a metabolic storage disorder, not an acute vascular event.
Central retinal vein occlusionSwollen disc with widespread retinal haemorrhages, venous stasis, cotton-wool spots and macular oedema.

How it appears in NEET PG

Fundus photographs are a standard NEET PG image format; this one is paired either with an acute vision-loss vignette or with a paediatric storage-disease vignette.

Frequently asked questions

Why is the fovea red in central retinal artery occlusion?

The inner retina loses its blood supply and becomes pale and opaque, but the fovea is thin and lies over the choroid, which is supplied separately, so it stands out as a red spot.

What are the main causes of CRAO?

Emboli from the carotid arteries or the heart are most common; inflammatory arteritis such as giant cell arteritis is an important cause to exclude.

Which other conditions show a cherry-red spot?

Sphingolipidoses and mucolipidoses, where storage material in ganglion cells makes the parafoveal retina opaque.

Sources

  1. Radiopaedia — Central retinal artery occlusion
  2. Harrison's Principles of Internal Medicine (textbook)

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For exam preparation and medical education only — not a substitute for clinical judgement, diagnosis or treatment of any patient.