admixed. (Courtesy of Nasreen A. Syed, MD.)

Degenerations

Rubeosis Iridis

Rubeosis iridis, or neovascularization of the iris, is a common finding in surgically enucleated blind eyes. It may be associated with a wide variety of conditions (Table 12-1). Histologically, the new vessels tend to lack supporting tissue and do not possess the encircling thick fibrous cuff seen in normal iris vessels. The vessels grow on the anterior surface of the iris and may extend to involve the angle. The neovascular membrane has a fibrous component consisting of myofibroblasts, which contract and eventually lead to angle closure due to formation of peripheral anterior synechiae. Neovascularization of the angle often results in neovascular glaucoma, a secondary type of glaucoma. Contraction of the membranes may also lead to ectropion uveae, an anterior displacement or dragging of the posterior iris pigment epithelium at the pupillary border. The anterior surface of the iris often becomes flattened. In advanced cases, atrophy of the dilator muscle, attenuation of the pigment epithelium, and stromal fibrosis occur (Fig 12-10).

Hyalinization of the Ciliary Body

Over time, the ciliary body processes become hyalinized and fibrosed, with loss of stromal cellularity. The thin, delicate processes become blunted and attenuated, and the stroma becomes more eosinophilic. This process is a normal aging change of the ciliary body and is not considered pathologic, although it does contribute functionally to the development of presbyopia.

Table 12-1