Purpose: To determine the cause of unilateral dilated tortuous episcleral vessels in a 34-year-old patient.
Methods: The patient underwent slit-lamp examination, visual field testing, tonographic measurement, orbital ultrasound examination, orbital color Doppler blood flow measurement, dye-enhanced computed topographic scan, and selective carotid angiography.
Results: Disk cupping and early scotoma were present. Gonioscopy showed Schlemm's canal engorged with blood. The only pathologic findings were an increased tonographic resistance to outflow and increased arterial and venous episcleral flow on color-coded Doppler sonography.
Conclusion: The origin of this episcleral vessel abnormality is still unknown.