Gonioscopy, is attempted, but the view is poor through the edematous cornea. However, no neovascularization of the iris (NVI) or hyphema is noted. Gonioscopy of the fellow eye is shown below:
In this patient, no angle structures are visible on gonioscopy in the left eye, indicating the angle is very narrow. This also suggests that the right eye likely has complete appositional closure, which obstructed aqueous outflow, resulting in extremely high IOP.
For comparison, in an eye with an open angle, the trabecular meshwork should be visible, as seen below:
You measure the patient’s glasses and find she is hyperopic with the following prescription:
OD +5.00 sph
OS: +4.50 sph
You orders aqueous suppressant drops and look for a consent form.
Click here to move on!
Case 4 Index