25], However, it needs to be noted that the expected postoperative IOP should not be lower than 10 mmHg, which is the estimated pressure of the episcleral
vein, indicating outflow resistance also exists in the downstream outflow tracts.
Various underlying mechanisms  propose to explain the cause of decrease in IOP during pregnancy, namely, an increase in uveoscleral outflow as a result of hormone levels modification, a decrease in systemic vascular resistance, decrease in episcleral
venous pressure, increased tissue elasticity, reduction in the aqueous humor production, and decreased corneoscleral rigidity.
Preclinical and clinical studies have also demonstrated that Rhopressa lowers episcleral
venous pressure, which contributes approximately half of IOP in healthy subjects.
The normal values reduce by 2-3mmHg due to the influence of progesterone on the episcleral
veins and, therefore, aqueous humour efflux.
The four corners of the graft were anchored with episcleral
bites to maintain position.
23) The minimally invasive strabismus surgery (MISS) technique described by Mojon (24) reduces the risk of anterior segment ischemia by sparing the perilimbal episcleral
In conjunction, the company's preclinical studies have demonstrated that Rhopressa lowers episcleral
venous pressure, which contributes half of IOP in healthy subjects; provides an additional mechanism that reduces fluid production in the eye and lowers IOP; inhibits both Rho Kinase (ROCK) and norepinephrine transporter (NET); As well as may have an anti-fibrotic effect on the trabecular meshwork and the potential to increase perfusion of the trabecular meshwork.
Slit lamp examination OD OS Conjunctiva Normal color Severe congestion Sclera White, silent eye Dilated episcleral
vessels Cornea Transparent, normal Mild epithelial edema, no thickness, no KP KP AC Absent in periphery, normal depth in the center; cellular Tyndall= [empty set] Iris "Iris bombe", fine IPS/ 360*; atrophic iris stroma, multiple rolling folds near the iris scleral insertion, supero-temportal rotation of the entire iris (Figure 1) Pupil Medium mydriasis, not reflex, pupillary diameter = 4 mm, mild corectopia (supero-temporal) Lens Normally positioned, transparent Lacrimal Normal Intense hyperlacrimation adnexa Abbreviations: AC--anterior chamber, KP--keratic precipitates, PIS-- peripheral iris synechiae Table 2.
In four animals, unclassified eye ball problem was recorded which were characterized by protruding eye ball and prominent and tortuous episcleral
Patients included were those who presented with pterygium of 2 or more millmeter over cornea, giving thick, fleshy appearance and obscuring the underlying episcleral
vessels (Donald Grade 3).
Included were the patients with age ranging from 20 to 60 years, who presented with watering, irritation, poor cosmetic appearance or decreased vision due to primary pterygium with an extent of 2 or more millimeter over cornea and thick, fleshy appearance in which episcleral
vessels underlying the body of the pterygium were partly/ totally obscured by fibrovascular tissue (Donald Grade 2 and 3).
One of such postulations is decrease episcleral
venous pressure with attendant upregulation of aqueous humor drainage despite normal production (11).