Previous angle closure glaucoma


Laser peripheral iridotomy. This is 
usually situated at the periphery in
the superior iris. 

Surgical iridectomy in an eye
with previous acute glaucoma. 
Notevthe irregular pupil.

The anterior chamber is usually shallow but may be normal in pseudophakia. The lens contains white opacities anteriorly. 
The iris may show atrophy from ischaemic changes with irregular pupil which may react poorly to light.
Peripheral iridotomy is usually present. You need to assess the patency of the iridotomies. 

In the examination:

  • remember that no all cases of acute glaucoma are treated with laser iridotomies. You may have patients who had 

  • had surgical iridectomies. With a casual examination, this may be mistaken for trabeculectomy without a 
    functioning bleb. The clue to this is the absence of a scleral flap, glaucoflecken and iris changes
  • examine the opposite eye for prophylactic treatment wither laser or surgical.


1. What is glaucoflecken?

2. How does plateau iris syndrome differ from primary angle closure glaucoma?


3. What are the ocular risk factors for primary angle closure glaucoma?

4. What tests can help to predict which patient would develop acute angle closure glaucoma?


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