Secondary to Vascular Disease in the

Central retinal vein thrombosis. This is a common cause of sudden blurring of the vision of one eye in the elderly. The retinal veins can be seen to be dilated and surrounded by haemorrhages. In some cases, recovery is marred by a rise in intraocular pressure, which typically appears approximately three months after the onset of the condition. The prompt appearance of this painful complication has given it the name of "hundred-day glaucoma". This type of glaucoma is usually difficult to control and even surgical measures can prove ineffective. A typical feature is the appearance of a vascular membrane over the anterior surface of the iris and sometimes the angle of the anterior chamber. This vascularised tissue lends a pinkish hue to the iris and is termed rubeosis iridis. Patients with a central retinal vein thrombosis followed by secondary glaucoma have another problem because there is a recognised association between chronic open-angle glaucoma and central retinal vein occlusion. This means that some patients who present with an occluded vein are found to have chronic glaucoma in the other eye.

Diabetes. Patients with severe diabetic retinopathy can also develop rubeosis iridis and secondary glaucoma. The vascular occlusive features of diabetic eye disease give it many resemblances to central retinal vein thrombosis and the secondary glaucoma that develops is also resistant to medical treatment. Panretinal laser photocoagulation, when applied early, causes regression of the rubeosis. The ultimate outcome is sometimes a blind and painful eye, which has to be removed.

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