Reduced ocular blood flow in asymmetric glaucoma: cause or effect?

Carotid Doppler measures blood flow velocity and vascular resistance index in the central retinal arteries and short posterior ciliary arteries. The blood flow profile of the optic nerve in chronic angle-closure glaucoma (CACG), however, has not been well documented. We report a 48-year-old female patient who presented with grossly asymmetric CACG and was evaluated by carotid Doppler. The patient had coexistent reduced blood flow in the ophthalmic artery of the more afflicted eye. Color Doppler imaging clarifies hemodynamic alterations in the glaucomatous optic nerve and helps to identify vascular aspects of the disease and its treatment.