|ANGLE RECESSION GLAUCOMA
SIGNS AND SYMPTOMS
Expect a rise in IOP, which may be substantial. An unexplained IOP rise
in the fellow eye often occurs in unilateral cases. There may be an associated
iridodyalysis in severe cases. Gonioscopy will reveal a deepening of the angle recess and
the appearance of excessive gray tissue (ciliary body) posterior to the scleral spur.
Intraocular pressure does not rise until long after the initial injury. Approximately 20 percent of patients with angle recession develop secondary glaucoma, depending on the extent of angle recession. Typically, two-thirds of the angle must be compromised in order for glaucoma to develop.
Controversy surrounds the etiology of IOP rise in traumatic angle
recession. One theory involves direct traumatic damage to the trabecular meshwork. Another
theory contends that particulate matter such as pigment and hemosiderin released at the
initial trauma damages the trabecular meshwork, causing scarring and poor filtration. Yet
another thought suggests that endothelial cells migrate and proliferate over the
trabecular meshwork in response to trauma, forming a Descemet's-like membrane that blocks
filtration. Interestingly, there seems to be a higher than expected incidence of POAG in
the non-traumatized fellow eye, leading some to speculate that these angle recession eyes
have a predisposition to IOP elevation.
Other Reports in This Section
Eyelids & Eyelashes | Conjunctiva & Sclera | Cornea
Uvea | Vitreous & Retina | Optic Nerve & Brain | Oculosystemic Disease
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