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Gonioscopic examination of a traumatic angle recession shows widening of the ciliary body band.

  • 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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