Comments. These resultant shock waves traversing the interior of the globe are responsible for other anterior segment damage accompanying angle recession, such as pupillary sphincter tears, iridodialysis, cyclodialysis and zonular tears.The shearing forces to the drainage angle result in a tear between the longitudinal and circular fibers of the ciliary muscle. Gonioscopy.org is a service to the profession by the Department of Ophthalmology at the University of Iowa.
Prostaglandin analogues should be avoided in the acute phase of trauma because of their potential to be pro-inflammatory. The membrane obstructs aqueous outflow, causing an open-angle form of glaucoma. Blanton FM. Chronic treatment with steroids can lead to steroid-induced glaucoma.Although the diagnosis of angle-recession glaucoma is evident after careful gonioscopy and optic nerve examination, other differential diagnoses for unilateral glaucoma should be considered. A small percentage of these people go on to develop glaucomatous optic neuropathy and vision loss days, months or even years later Angle recession was first described by Collins in 1892It has been reported that up 60% of eyes with non-penetrating or concussive trauma will develop some degree of angle recessionThe main risk factor for angle recession is trauma.
Argon laser trabeculoplasty in secondary form of open angle glaucoma. Robin AL, Pollack IP.
traction on the iris root leading to a tear between the longitudinal and circular muscles of the ciliary body. Angle recession glaucoma (ARG) is a secondary open angle glaucoma that is associated with ocular trauma. In some cases, this membrane may contract, resulting in angle-closure glaucoma.As mentioned previously, 5 to 20 percent of eyes with angle recession develop angle-recession glaucoma. A small percentage of these people go on to develop glaucomatous optic neuropathy and vision loss days, months or even years later . These include—but are not limited to—pseudoexfoliative glaucoma, neovascular glaucoma, uveitic glaucoma, lens-particle glaucoma and phacolytic glaucoma.Glaucoma drainage devices have demonstrated some benefit, but their success rates are lower in angle-recession glaucoma than with other types of glaucomas. Treatment for ARG is generally the same as for primary open angle glaucoma save for a few exceptions noted below. Girkin, et al. Uploaded on Oct 1, 2012. Spaeth GL.
Traumatic hyphema, angle recession, dexamethasone hypertension, and glaucoma. Traumatic or concussion chronic glaucoma. In eyes with limited visual potential, a cyclodestructive procedure may be an alternative option.A patient who has experienced blunt ocular trauma should receive a comprehensive eye exam to check for the presence of angle recession and other abnormalities. D’Ombrain. Tumbocon, J. and Latina, M. Angle Recession Glaucoma. The resultant glaucoma is not due to angle recession per se, but is secondary to initial trauma to the trabecular meshwork, with subsequent degenerative changes and scarring, which leads to obstruction of aqueous outflow.Less often, a hyalinized membrane may cover the inner surface of the trabecular meshwork.
Last modified by Jeffrey G. Gross, MD on Oct 1, 2012. On the pathological examination of three eyes lost from concussion. Tesluk GC, Spaeth GL. Angle recession is reported to occur in 20 to 94 percent of eyes after blunt trauma and is often masked initially due to the presence of concomitant hyphema, which results from shearing of the anterior ciliary arteries. This exam finding, in the presence of elevated pressure and nerve damage, leads to the diagnosis of angle recession glaucoma. Download (3.5 mb) File number: 982. Sometimes, an eye injury can damage this drainage system, a condition called angle recession. Although different underlying mechanisms may be involved with the initial injury, the resulting optic neuropathy and visual field loss is secondary to elevated IOP from reduction in aqueous outflow through the trabecular meshwork. However prostaglandin analogues have a theoretical benefit of bypassing the dysfunctional trabecular meshwork by increasing uveoscleral outflow and can be used after the acute phase is over. Recession of the anterior chamber angle is a common slit lamp and gonioscopic finding following concussive ocular trauma.
Gonioscopy.org is a service to the profession by the Department of Ophthalmology at the University of Iowa. Two other proposed mechanisms to explain the elevated pressures are University of Iowa Carver College of Medicine.
The risk of angle-recession glaucoma correlates with the extent and severity of angle recession.In general, angle-recession glaucoma is more difficult to control medically and surgically than other types of glaucomas. Filipe JA, Barros H, Castro-Correia J. Sports-related ocular injuries. Department of Ophthalmology & Visual Sciences. Tonjum AM.
Some normal eyes have a broad ciliary body band thus it is important to compare suspected areas of recession to the opposite eye to see what the “normal” ciliary body band looks like to avoid mistaking physiologic or even 360-degree recession as normal.
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