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Angle Recession Glaucoma

Angle Recession Glaucoma Causes

Any cause of eye trauma that does not penetrate the eye can result in angle recession glaucoma.  

The episode may be seemingly trivial and forgotten. The circumstances of the injury can be quite variable but are often due to trauma from high-speed or fast-moving blunt objects or projectiles, such as the following: 

  • Airbags

  • Fists

  • Stones

  • Balls

  • Champagne stoppers

  • Bungee cords

  • Tree branches

The most common types of blunt trauma occur as a result of the following:  

  • Sports injuries (e.g., boxing, paintball)

  • Motor vehicle accidents (e.g., airbag deployment)

  • Assaults

  • Falls

  • Military combat injuries

  • Accidents (e.g., industrial, farm, home)

  • Other (e.g., school accidents, natural disasters)

Angle Recession Glaucoma Symptoms

Like most people with other forms of glaucoma, if you have angle recession glaucoma, you may not have any specific eye or visual complaints.  

Although eye trauma invariably occurs before angle recession, it is common to have forgotten details of the injury or even the entire episode after a number of years have passed. During regular eye examinations, an ophthalmologist (a medical doctor who specializes in eye care and surgery) may be helpful in eliciting otherwise forgotten information that could point to the cause of the angle recession.

When to Seek Medical Care

Regular eye examinations with an ophthalmologist are important to screen for angle recession, especially since it is often caused by eye trauma and details of such an injury or even the entire episode may have been forgotten after a number of years. Regular eye examinations are particularly critical for people who are at a higher risk for glaucoma in general, such as African Americans and elderly individuals. 

Your initial visit to an ophthalmologist is extremely important in the evaluation for angle recession glaucoma or other possible eye diseases that could cause increased IOP. During this visit, the ophthalmologist will ask you about your past ocular history, including any previous eye/head trauma, eye surgeries, or eye diseases.

Questions to Ask the Doctor

  • Is my eye pressure elevated?

  • Are there any signs of internal eye damage due to an injury?

  • Are there any optic nerve abnormalities on my examination?

  • Is my peripheral vision normal?

  • Is treatment necessary?

  • How often should I undergo follow-up examinations?

Exams and Tests

Ideally, angle recession should be discovered before glaucoma develops, so that the actual risk of glaucoma can be assessed and appropriate care can be arranged. In determining whether or not you have angle recession, your ophthalmologist performs different tests during an office examination. Each test is described below. 

 

  • Angle recession is always diagnosed by a test called gonioscopy.

    • During gonioscopy, the drainage angle of your eye is checked. The angle of the eye is formed where the iris and the cornea come together inside your eye. This test is important to determine if the angles are open, narrowed, or closed and to rule out any other conditions that could cause elevated IOP. To view the angle, a special contact lens is placed on the eye.

    • During this test, your ophthalmologist examines the angle for characteristic features of angle recession. Your eye doctor also compares the affected angle with the angle of the fellow eye. When many years have passed following the injury, recognizing angle recession may be difficult.

    • If the eye is severely traumatized and gonioscopy cannot be performed, then a high-frequency ultrasound biomicroscopy may be used to examine the angles for any abnormalities.

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