- Separation between the longitudinal and circular muscle of the ciliary
body (commonly caused by blunt injury to the eye)
- Incidence of intraocular pressure elevation appears to be directly
related to the extent of angle involvement (may require at least 180
or 270 degree involvement)
- Clinical features:
- Symptoms:
- May be asymptomatic
- In the acute phase following injury, early onset glaucoma
may be related to concurrent uveitis or hyphema
- Signs:
- Intraocular pressure may remain normal for years or decades
before becoming elevated
- Associated findings may include corneal edema, pupillary
sphincter tear, subluxated lens, or hyphema
- Gonioscopic examination may demonstrate:
- The classic finding of a widened ciliary body band
- Posterior iris displacement
- Baring of the ciliary processes
- Management:
- Routine follow-up of patient with recessed angle but no IOP
elevation
- Topical steroid therapy may be used with early post-traumatic
IOP elevation believed secondary to increased outflow resistance
from trabecular edema and inflammation
- Anti-glaucoma medications such as aqueous suppressants (e.g.
beta adrenergic antagonists), alpha2 adrenergic agonist, and miotics
may be given
- Surgical treatment (e.g. glaucoma filtration surgery) may be
indicated for glaucoma unresponsive to medical therapy
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