Dr.MIRIAM ABRAHAM, M21676
43 year old male presented with reduced vision right eye since 1 week with pain and redness.Vision RE was NO PL and LE was 6/9.IOP in RE was 30mmHg and LE was 20 mmHg .Anterior segment RE showed corneal edema,NVI at pupillary border and RAPD with NVA all 4 angles and grade I-II angles on gonioscopy.Fundus RE showed generalized arterial narrowing,hemorrhages all 4 quadrants,pale retina with cherry red spot.LE was normal with all angles open on gonioscopy and normal fundus.Initial impression was RE combined CRAO with CRVO occlusion with secondary NVG .FFA showed delayed choroidal,arterial and venous filling suggesting ocular ischemic syndrome RE.Doppler showed near total occlusion of internal carotid artery on both sides.Blood workup revealed raised Hb levels and reduced Erythropoetin levels confirming diagnosis of Polycythemia vera.Patient was started on antiglaucoma medications with PRP for LE ,phlebotomy and injection LMW heparin followed by daily dose of statins and anti platelets.
PRESENTATION NOT RECEIVED FROM THE AUTHOR.
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