Neovascular glaucoma, endophthalmitis and evisceration

A retrospective study of 35 patients undergoing evisceration at Moorfields Eye Hospital, London between 1982 and 1987, revealed that 60% were known to be suffering from neovascular glaucoma, the majority as a result of a central retinal vein occlusion. 76% of these rubeotic eyes subsequently developed an endophthalmitis and required evisceration. 81% of this rubeotic, infected group were being treated with topical steroids prior to developing a suppurative keratitis and ensuing endophthalmitis. Every patient (9) with neovascular glaucoma that was debilitated (due to a variety of underlying medical conditions--4 were diabetic) developed an endophthalmitis and 78% of these were also using topical steroids. This study reveals that there may be a specific group of patients with absolute neovascular glaucoma, i.e. being debilitated and using topical steroids, who might appear to be susceptible to developing severe intraocular infection.