Glaucoma
Angle Recession Glaucoma
Also known as: angle recession, angle recession glaucoma, traumatic glaucoma, post-traumatic glaucoma, widened ciliary body band, blunt trauma glaucoma, ciliary body tear
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Blunt trauma can tear the ciliary body, and the trabecular meshwork beside the tear degenerates over time and drains less well. The angle stays open, so this is a secondary open-angle mechanism. The pressure rise can appear years after the injury, often long after the patient has forgotten it. Glaucoma is most often seen from about 3 years to 10 years or more after the trauma. The fellow eye is also at risk: in one series, about half of patients who already had angle recession glaucoma in the injured eye later developed open-angle glaucoma in the other eye. An eye with angle recession and no glaucoma is followed as a glaucoma suspect for life.
Recognition
Symptoms: what patients report
- Usually none
- A history of blunt eye injury, sometimes decades earlier and not volunteered
- Gradual visual field loss in established glaucoma
Signs: what the examination shows
- Irregular widening of the ciliary body band on gonioscopy, best judged against the fellow eye
- Posteriorly displaced iris profile
- Mottled pigment on the trabecular meshwork or at Schwalbe's line
- Signs of old blunt trauma: a distorted pupil, an irregular pupillary ruff, sphincter tears, iridodialysis, lens displacement or a traumatic cataract
- Intraocular pressure within the normal range or raised
- The slit-lamp examination may be unremarkable
What OptoGuide™ covers for angle recession glaucoma
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Centre for Eye Health — Chair-side Reference: Secondary Glaucomas
- Centre for Eye Health — Chair-side Reference: Gonioscopy and the Anterior Chamber Angle
- Tesluk GC, Spaeth GL. The occurrence of primary open-angle glaucoma in the fellow eye of patients with unilateral angle-cleavage glaucoma. Ophthalmology 1985;92:904-11