Neovascularization in the Iris: Rubeosis Iridis
Rubeosis iridis is neovascularization in the
iris that occurs in various retinal dis-orders.
The most frequent causes of rubeosis iridis (Fig. 8.12) areprolifera-tive diabetic retinopathy and retinal vein occlusion. Retinal periphlebitis is aless frequent
cause of neovascularization in the iris.
Neovascularization in thestroma of the iris isasymptomaticfor
the patient. Neovascularization in the
angle of the anterior chamber is irreversible and produces secondary
angleclosure glaucoma with the typical symptoms
of acute glaucoma: loss of visual acuity, intense pain, conjunctival and
ciliary injection, and a “rock hard” eye-ball upon palpation (see Fig. 10.17).
Acute glaucoma due to other causes such as acuteangle closure glaucoma should be excluded.
Rubeosis iridis is essentially tanta-mount to
the loss of an eye. Usually it leads
to irreversible blindness. Prompt
laser treatment of retinal disorders is crucial to prevent rubeosis iridis.
Sec-ondary angle closure glaucoma is treated by transscleral freezing of the
ciliary body (cyclocryotherapy) to reduce intraocular pressure. Where this
fails or the eye shrinks (phthisis bulbi) and the patient experiences intense
pain, enucleation of the eye is indicated.
Prompt laser treatment is important in
proliferative diabetic retinopathy to prevent rubeosis iridis.