Ocular ischaemic syndrome

Usually males in 60s and unilateral.

Secondary to carotid artery obstruction – atherosclerosis related (DM, HTN). Other causes are GCA, trauma, dissecting aneurysm or inflammation.

Symptoms: gradual reduction in vision with pain. May have history of amaurosis fugax.

Signs: iris neovascularisation, AC reaction, occasional IOP rise, retinal arteries attenuation with dilated nontortuous retinal veins, retinal haemorrhages, disc or retinal neovascularisation.

Investigations: FFA – delayed filling of veins (main finding).

Differential to think of: GCA and CRVO


  1. Carotid endarterectomy if suitable (may worsen patients with rubeosis).
  2. Medical therapy – BP, DM.
  3. PRP – eyes with rubeosis/neovascularisation.
  4. Anti-VEGF – macular oedema

Location Birmingham Midlands Eye Centre 76 Dudley Road Birmingham B18 7QH UK Phone 0121 554 3801 Hours Mr Ch'ng | Vitreoretinal Clinic Sessions: Monday: 8.30am - 12.30pm Wednesday (alternate): 8.30am - 5.00pm Thursday: 8.30am - 12.30pm Friday: 8.30am - 12.30pm | Vitreoretinal Theatre Sessions: Wednesday (alternate): 8.30am - 5.00pm & Friday (emergency cases): 1.30pm - 5.00pm | Eye Casualty Session: Monday 1.00pm - 4.30pm |
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