By Wallace L.M. Alward, Frederick C Blodi
Gonioscopy is a method of exam of the iridocorneal attitude of the attention. it's a severe component of the exam of all sufferers, fairly people with glaucoma. it's a a part of the attention exam that is tremendous tough for trainees to profit. a few older practitioners have by no means develop into professional in gonioscopic innovations. This atlas provides all facets of the process from the elemental sciences during the ideas, exam ideas and interpretation of findings.
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Extra info for Colour Atlas of Clinical Gonioscopy
The anterior cilia1·y body and iris insert over the posterior trabecular meshwork. There is histopathological and clinical evidence of traction on the pillars . The traction may cause compaction of the trabecular spaces, with impairment of aqueous outflow. Goniotomy and trabeculotomy cut through the tight pillru·s and relieve the compaction of the trabecular spaces (Anderson, 1981). 122 122 Fifteen-year-old with primary infantile glaucoma. She was first seen at age six with severe buphthalmos. There is generalized atrophy of the iris with islands of visible pigment epithelium.
83 39 Color Atlas of Gonioscopy Ciliary Body Band The iris usually inserts into the concave face of the ciliary body, leaving some of the ciliary body visible anterior to the iris. The ciliary body band is seen as a light gray to dark brown band located just anterior to the iris and posterior to the scleral spur (84-86). This band can be quite wide in myopic or aphakic eyes and nan-ow to absent in hyperopic eyes or eyes with anterior insertions of the iris. If the ciliary body band is abnormally deep and not symmetric with the other eye, the possibility of angle recession, cyclodialysis, or unilateral high myopia must be considered .
11 0 Spaeth's classi fication system includes the level of iris insertion. A, anterior to trabecular meshwork; B, behind Schwalbe's line; C, posterior to scleral spur; D, deep, into ciliary body face; E, extremely deep. (George L. Spaeth, MD. Published courtesy of Trans. Ophthalmol. Soc. UK. ) 111 In Spaeth's classification the width of the angle is approximated by a line tangential to the iris about onethird of the way from the iris root to the pupil and a line tangential to the face of the trabecular meshwork.