Ophthalmic examination OS revealed raised intraocular pressure (37 mm Hg; reference interval 7-16 mm Hg), mydriasis, conjunctival and episcleral hyperemia, shallow anterior chamber due to anterior displacement of the lens and iris, rubeosis
iridis, and engorgement of the pecten.
iridis and retinoblastoma and pseudoglioma.
Table 1 Some causes of facial erythema Atopic eczema Seborrhoeic eczema Sebopsoriasis Allergic contact dermatitis Irritant dermatitis Photocontact dermatitis Rosacea Lichen planus Lichen planus actinicus Carcinoid Glutamate sensitivity Table 1 Some causes of facial erythema Diabetic rubeosis
Topical steroids Alcohol flush 'Weather beating' Mitral stenosis Poikiloderma Rothmund-Thomsen Sarcoid Lupus erythematosus Dermatomyositis Pemphigus foliaceus Erysipelas Hansenosis Lymphoma Haemangioendothelioma Keratosis rubra faciei of Brocq Ulerythema ophryogenes Erythrose peribuccale of Brocq Riehl's melanosis Perioral dermatitis Erythromelanosis faciei et colli
This is because rubeosis
is usually/ a consequence of some other advanced, or significant ocular pathology, which has caused retinal ischaemia.
Complications include secondary cataract, iris rubeosis
, uveitis, secondary glaucoma and, eventually, phthisis bulbi.
In people with diabetes, and those with suspected previous vascular occlusion, you should examine the iris carefully for evidence of rubeosis
iridis prior to dilatation of the pupil.
Neovascularisation of the iris (NVI), also known as rubeosis
iridis, occurs when new blood vessels are created from preexisting iris capillaries found near the pupillary margin (Figure 1) (10) and iris root.
Complications include secondary cataract, rubeosis
iridis, uveitis, secondary glaucoma, retinal detachment and phthisis bulbi (atrophy of non-functional eye).
One such factor, found in elevated concentration in the aqueous humour of patients with rubeosis
and NVG, is vascular endothelial growth factor (VEGF).
iridis (NVI) may subsequently lead to the development of neovascular glaucoma.
In addition, the retinal ischaemia drives the development of rubeosis
The anterior segment may also provide additional evidence to help confirm the diagnosis such as rubeosis
in the case of a diabetic presenting with a vitreous haemorrhage.