Simultaneous Occurrence of Neovascular Glaucoma with Proliferative Diabetic Retinopathy and Carotid Occlusive Disease: A Case Report

Neovascular glaucoma secondary to carotid occlusive disease is uncommon. We report the case of a 60-year-old female who presented to the emergency department with right eye pain, redness, blurred vision, dizziness, and body pain for three days. Examination revealed an intraocular pressure (IOP) of 45 mmHg in the right eye. Carotid Doppler ultrasound, performed to evaluate for carotid occlusive disease, demonstrated 80% occlusion of the right internal carotid artery. Subsequent computed tomography angiography (CTA) confirmed significant stenosis (at least 70%) of the proximal right internal carotid artery. The patient was referred to vascular surgery and underwent a thromboendarterectomy of the right internal carotid artery. At nine months of follow-up, the patient demonstrated significant improvement in ocular pain and noticeable reduction in IOP to 16 mmHg. This case highlights the importance of clinical reasoning in identifying less common etiologies, such as carotid artery stenosis, in patients with treatment-resistant neovascular glaucoma.