Eales' disease is an idiopathic vasculitis that affects the peripheral retina. It is characterized by recurrent vitreous hemorrhage as a complication of retinal neovascularization. It is more prevalent in India and affects young males. Here, we present a patient with neovascular glaucoma as a rare first presentation of Eales' disease. This is a 24-year-old Indian male, who complained of a sudden decrease in vision in the left eye over less than 24 hours, along with frontal headache and eye pain for the last three weeks. Ocular examination revealed peripheral retinal ischemia in the right eye, very high intraocular pressure, rubeosis iridis, vitreous hemorrhage and extensive retinal ischemia in the left eye, vascular sheathing and neovascularization in both eyes. The purified protein derivative skin test was positive. The patient was managed with anti-glaucoma, intravitreal anti-vascular endothelial growth factor and laser photocoagulation. Systemic steroids and anti-tuberculous therapy were also initiated. Neovascular glaucoma is an infrequent complication of Eales' disease. However, the lack of early detection of the disease in the early stages might lead to such serious complications.
Introduction:Keratoconus is a progressive degenerative corneal disease of variable severity. Its management includes medical and surgical treatment. Corneal crosslinking (CXL) is being increasingly used to stabilize the condition. Macular phototoxicity is a well-known side effect of light exposure; however, its incidence after treatment with riboflavin and UV light is unknown. This study reported the clinical features of a patient with macular phototoxicity after UV-A exposure and described the structural and angiographic retinal changes observed in the patient.Patient, Clinical Findings, and Diagnosis:A 37-year-old man with keratoconus underwent corneal refractive surgery (topography-guided custom ablation with accelerated and high-fluence CXL). Postoperatively, he had decreased vision in the operated eye. Ophthalmoscopy, spectral-domain optical coherence tomography, and fluorescein angiography revealed retinal pigment epithelial changes, ellipsoid zone disruption, and window defects, respectively. The patient was diagnosed with macular phototoxicity. The corrected distance visual acuity stabilized at 20/100 after 6 months.Conclusions:Macular phototoxicity may occur after UV-A exposure during CXL. The use of accelerated and high-fluence protocols might have contributed to its occurrence in this patient.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.