Nazima Bai A, K. Kanchana

BACKGROUND Neovascular glaucoma is a potentially blinding secondary glaucoma without pupillary block. It is associated with severe, diffuse and chronic retinal ischemia. Prevention and treatment of neovascular glaucoma early in its course is important as neovascular glaucoma carries a very guarded prognosis. The objective of the study is to find out the common aetiological factors of neovascular glaucoma in a tertiary level hospital in southern part of Kerala. MATERIALS AND METHODS This is a descriptive study of 66 cases of neovascular glaucoma which attended a tertiary level hospital in southern part of Kerala. The aetiological factors and clinical presentation of various cases of neovascular glaucoma has been analysed. Information extracted from the patients with particular reference to diabetes mellitus, hypertension, cardiovascular disease, uveitis, glaucoma, trauma and recent onset defective vision were elicited. RESULTS From the study, it was found that proliferative diabetic retinopathy is the most common cause of neovascular glaucoma (35.7%), central retinal vein occlusion stands second (30%) and unknown causes (11.4%) stand third. Other causes of neovascular glaucoma seen in the study were chronic uveitis (10%), ocular ischemic syndrome (4.3%), central retinal artery occlusion (2.9%), branch retinal vein occlusion (2.9%), Coats’ disease (1.4%) and post radiotherapy (1.4%). CONCLUSION Neovascular glaucoma was found to be an important cause of secondary glaucoma. Visual acuity at presentation was no perception of light in majority of cases with gonioscopy showing closed angle. Diabetes mellitus and hypertension has strong association with neovascular glaucoma. Most common causes of neovascular glaucoma are proliferative diabetic retinopathy and central retinal vein occlusion. Less frequent causes are chronic uveitis, ocular ischemic syndrome, central retinal artery occlusion, branch retinal vein occlusion, Coats disease and post radiotherapy. Early detection of cases which can progress to neovascular glaucoma is important as neovascular glaucoma is intractable, once the angle gets closed with fibro vascular membrane.