Ischemic oculopathy. A manifestation of carotid artery disease.

Six patients experienced ischemic oculopathy, a condition in which there is ischemia in both the anterior and posterior segments of the eye caused by occlusive carotid artery disease. The abnormalities in the anterior segment include episcleral vascular congestion, anterior chamber flare and cells, a mid-dilated, sluggish, or unreactive pupil, rubeosis iridis, and abnormal intraocular pressure. The posterior segment abnormalities include ischemic insults to the retina or optic nerve, venous-stasis retinopathy, and low ophthalmodynamometry values. Ophthalmodynamometry is particularly helpful in recognizing the pathogenesis of this disorder. Superficial temporal artery-middle cerebral artery anastomosis surgery may have particular merit for patients with ischemic oculopathy.