Open-angle glaucoma secondary to blood clot in the Schlemm's canal following scleral buckle surgery and its treatment with tPA

Obstruction of the episceral venous system can present with glaucoma.(1) We present two patients who were referred to us for management of acute glauc oma with presumed episceral venous compression. The first patient had open- angle glaucoma with probable elevated episcleral venous pressure and blood in the Schlemm's canal, following a 360 degrees scleral buckle surgery. The second patient had open-angle glaucoma from delayed peribulbar hemorrhage following uncomplicated cataract surgery with blood in the Schlemm's canal. Both patients were successfully treated with intracameral injection with t issue plasminogen activator (tPA).