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Published on: February 15, 2022
Dilated episcleral veins with secondary open angle glaucoma
Rajul S Parikh1, Savari Desai, Kulin Kothari
1Department of Glaucoma, Bombay City Eye Institute & Research Centre, Mumbai, India. drparikhs@gmail.com
Indian Journal of Ophthalmology
|February 26, 2011
Summary
This case study describes a patient with dilated episcleral veins and secondary open-angle glaucoma. Surgical management involving sclerotomy was crucial for addressing high episcleral venous pressure and managing choroidal effusion.
Area of Science:
- Ophthalmology
- Vascular Ophthalmology
Background:
- Dilated episcleral veins can be associated with elevated intraocular pressure (IOP).
- Secondary open-angle glaucoma requires careful management, especially when linked to vascular anomalies.
Observation:
- A 65-year-old female presented with bilateral eye redness and elevated IOP (38 mm Hg) in the right eye.
- Ocular examination revealed dilated episcleral veins; systemic workup ruled out common causes like carotid cavernous fistula.
- Medical management failed to control the high IOP, necessitating surgical intervention.
Findings:
- Trabeculectomy with partial thickness sclerectomy and sclerotomy was performed on the right eye.
- Initial sclerotomy was not deepened, leading to choroidal effusion, which resolved after deepening the sclerotomy into the suprachoroidal space.
- Postoperative choroidal effusion occurred but resolved with conservative treatment.
Implications:
- This case underscores the significance of appropriate sclerotomy technique in managing glaucoma associated with high episcleral venous pressure.
- Proper surgical planning and intraoperative adjustments, such as deepening the sclerotomy, are vital for preventing and managing complications like choroidal effusion.
- Understanding the relationship between episcleral venous dilation and glaucoma is crucial for effective patient care.
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