Neovascular Glaucoma

The elderly patient who presents with a blind and painful eye and who might also be diabetic should be suspected of having neovascular glaucoma. Often, a fairly well-defined sequence of events enables the diagnosis to be inferred from the history, as in many cases secondary neo-vascular glaucoma arises following a central retinal vein occlusion. Following retinal vein occlusion, patients typically notice that the vision of one eye becomes blurred over several hours or days. Some elderly patients do not seek attention at this stage and some degree of spontaneous recovery can seem to occur before the onset of secondary glaucoma. Fortunately, only a modest proportion of cases develops this severe complication, which usually occurs, surprisingly enough, after 100 days, hence the term "hundred-day glaucoma". Once the intraocular pressure rises, the eye tends to become painful and eventually degenerates in the absence of treatment, and sometimes even in spite of treatment. This form of secondary glaucoma remains as one of the few indications for surgical removal of the eye, if measures to control intraocular pressure are unsuccessful.

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