This patient had raised intraocular pressure.

Cross-section of the anterior chamber.

• What are the abnormalities in the above specimen?


Answer
1. Closure of the trabecular meshwork from anterior synechiae.
2. Presence of abnormal vessels on the anterior iris stroma
3. Contraction of the iris causing ectopia uvea
4. Lacy vacuolation of the pigmented layer on the posterior surface of the iris.
(see picture below for explanations)

 
What is the diagnosis?

.
Answer
Proliferative diabetic retinopathy with rubeosis iridis and angle-closure glaucoma.
Although other proliferative disorders such as ischaemic central retinal vein occlusion may give the same appearance, the lacy vacuolation is characteristic of poorly controlled diabetes mellitus.