The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Neovascular glaucoma

Photo by Professor Chua Chung Nen

This 53 year-old diabetic man was referred because of blurring of the right eye. Examination revealed a VA of 6/60 in the right eye and 6/18 in the left. The IOP measured 46mmHg in the right eye and 18mmHg in the left eye. The right eye showed rubeosis iridis and new vessels elsewhere in the retina. The left eye showed new vessels of the disc. He was started on oral acetazolamide and topical timolol and steroid. The IOP decreased to 20mm Hg. Argon laser PRP was performed totaling around 2000 burnts in each eye (on two sessions within one week). However, the IOP of the right eye returned to 45mmHg two days after the oral acetazolamide was stopped. Trabeculectomy with MMC was performed. Post-operatively, the IOP was controlled at 14mmHg despite hyphaema during the post-operative period.

 

Hyphaema post-trabeculectomy for neovascular glaucoma. Despite the flat bleb, the IOP was normal.

 

Gonioscopy with Goldmann lens shows patent sclerotomy at 4 weeks post-operative and no signs of iris neovascularization. The IOP was normal.

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