Idiopathic elevated episcleral venous pressure with secondary glaucoma

Idiopathic elevated episcleral venous pressure (IEEVP) is a rare condition that can lead to glaucoma, which can be difficult to manage. This case report aims to educate clinicians on the importance of considering IEEVP in the differential diagnosis of elevated intraocular pressure (IOP) in the presence of engorged episcleral veins.

We describe a patient who presented to the office with high IOPs in the presence of engorged episcleral veins. We diagnosed the patient with glaucoma and referred the patient to a glaucoma specialist. The elevated IOP became difficult to manage medically, and the patient underwent a trabeculectomy in the right eye. We eventually diagnosed the patient with IEEVP.

Although rare, IEEVP should be considered when the patient presents with elevated IOP in the presence of engorged episcleral veins. Idiopathic elevated episcleral venous pressure is often difficult to manage both medically and surgically.