- Clinical features:
- The peripheral iris attaches anteriorly in the anterior chamber
angle.
- Attachment may extend to anterior portion of ciliary body, scleral
spur, corneoscleral trabecular meshwork, Schwalbe's line or to
cornea.
- May be localized or broad and extensive.
- May cause acute-angle closure glaucoma.
- Secondary shallowing of the anterior chamber and resulting blockage
of aqueous outflow via the trabecular meshwork may cause chronic
angle-closure glaucoma.
- Sometimes is confused with a normal prominent uveal meshwork
(i.e. iris processes).
- May develop in association with a number of ocular conditions such
as neovascular glaucoma, iris bombé, heterochromic cyclitis,
chronic iridocyclitis, pigmentary glaucoma, post-laser trabeculoplasty,
post-scleral buckling procedure, post-trabeculectomy, ciliary body
tumors, and essential iris atrophy.
- Gonioscopic examination demonstrates a uniform and solid iris segment
blocking the view of angle structure.
- Management:
- Peripheral laser iridotomy is recommended for patients with
documented acute or subacute angle-closure glaucoma attack, persistent
increase IOP and PAS without underlying secondary causes.
- Other treatment modalities include anti-glaucoma medications,
laser iridoplasty, anterior chamber paracentesis, surgical iridectomy,
synechialysis, and filtration surgery.
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