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

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

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Subtle rubeotic iridis

Photo by Professor Chua Chung Nen

This 65 year-old man developed a central retinal vein occlusion six months ago. Pan-photocoagulation was performed because of retina ischaemia. At the most recent visit, the intraocular pressure was raised at 35mm Hg despite the absence of obvious new iris vessels on slit-lamp examination. However, gonioscopy revealed the presence of blood in the trabecular meshwork and fine new vessels at the angle. Sometimes new vessels in central retinal vein occlusion may begin in the angle instead of the pupillary edge. Gonioscopy is useful to identify such vessels and further pan-photocoagulation should be performed to induce regression of the vessels.

 

Normal iris on slit-lamp examination.

 

Blood in the angle of the trabecular meshwork appearing as thick red line.

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