Closed angle glaucoma; Iris and Lens or Iris and Cornea! - USMLE Forums
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Old 07-10-2011
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Eye Closed angle glaucoma; Iris and Lens or Iris and Cornea!

hey....FA 2010 and 2011 say different things for closed angle glaucoma......can someone please clarify the pathophysiology of closed angle glaucoma?

thanks
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Old 07-10-2011
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Closed angle is due to closure of iridocorneal angle, ciliary ,iris.
Due to short axial length of eye.
Due to anterior placement of lens...etc

As a result of above reason aqueous flow from the posterior chamber to the anterior chamber is blocked. When pupillary block occurs along with the iris, the increasing pressure in the posterior chamber causes the pliable iris, and make it to bow forward resulting in iris bombe Iris bombe further closes the already narrow angle and compromises aqueous drainage, resulting in increasing IOP. Increased sympathetic tone may also results the same.
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let me just clarify my question a bit.......is the narrowed-angle btw the lens and iris (like it says in FA 2011) or btw the iris and cornea (FA 2010)?
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It's between the iris and cornea
Have a look at this

Closed angle glaucoma; Iris and Lens or Iris and Cornea!-glaucoma-angle.jpg
click image to enlarge
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Old 07-10-2011
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Quote:
Originally Posted by BrianDM View Post
It's between the iris and cornea
Have a look at this

Attachment 1758
click image to enlarge
oh ok... also, if you look at the pic on the right....it seems as if the flow is doing a "U-turn" because the iris-lens are "stuck" together (narrowing of the iris-lens angle)......i honestly think its a combo of both, like the iris-lens angle is closed so the posterior chamber is full of aqeous humor, and then that is pushing the iris towards the cornea and causing the iris-cornea angle closure...would you agree with that, or i could be wrong?
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Quote:
Originally Posted by jattdoc View Post
oh ok... also, if you look at the pic on the right....it seems as if the flow is doing a "U-turn" because the iris-lens are "stuck" together (narrowing of the iris-lens angle)......i honestly think its a combo of both, like the iris-lens angle is closed so the posterior chamber is full of aqeous humor, and then that is pushing the iris towards the cornea and causing the iris-cornea angle closure...would you agree with that, or i could be wrong?
Yes, I agree.
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Old 07-11-2011
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Quote:
Originally Posted by jattdoc View Post
let me just clarify my question a bit.......is the narrowed-angle btw the lens and iris (like it says in FA 2011) or btw the iris and cornea (FA 2010)?
Angle closure glaucoma is due to a narrowing or completely closure of the angle between the cornea and iris.

Wikipedia says of angle closure glaucoma ... "the iridocorneal angle is completely closed because of forward displacement of the final roll and root of the iris against the cornea resulting in the inability of the aqueous fluid to flow from the posterior to the anterior chamber and then out of the trebecular network"

That is why East Asians are prone to developing angle closure glaucoma because they naturally possess a shallower anterior chamber (space between the iris and cornea)

Hope this helps

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Ophthalmology ..my favorite CK subject
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Old 08-10-2011
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Quote:
Originally Posted by jattdoc View Post
hey....FA 2010 and 2011 say different things for closed angle glaucoma......can someone please clarify the pathophysiology of closed angle glaucoma?

thanks
here what happens .. closure angle glaucoma usually occurs in semidilated pupil and with pupillary dilation the pupillary margin of the iris slightly touches the anterior surface of the lens and as u know acut angle occurs in small eyes (hypermetrope) which make this attachment between the lens and the iris make it difficult for the aqueaous to flow from the posterior chamber to anterior >>> iris bombe as aquous acumulate >> root of the iris as a result will approximate toward the cornea closing the angle >> glaucoma occurs
wish that is helpful
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