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 section of the exam of all sufferers, really people with glaucoma. it's a a part of the attention exam that is tremendous tricky for trainees to benefit. a few older practitioners have by no means turn into professional in gonioscopic suggestions. This atlas offers all points of the method from the fundamental sciences during the rules, exam innovations and interpretation of findings.

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J. Ophthalmol. 1955; 53: 767-782. , 1967). The iris processes can be broad or lacy and delicate. The changes to the a ng le gene rally affect the entire angle, but they may also be restricted to a small area (131). The iris usually inserts anteriorly and obscures the scleral spur. Rieger's anomaly demonstrates all of the 129 129 Histopathology of Axenfeld-Rieger's anomaly. Note the markedly thickened Schwalbe's line (S) with adherent iris process (arrow). 130 130 Axenfeld's anomaly with partially detached Schwalbe's ring within the anterior chamber.

Some manufacturers recommend soaking lenses in 2% glutaraldehyde or dilute (1: 10) household bleach (Ocu l ar Instruments, Bellevue, Washington). Most lenses can be gas-sterilized and some g lass lenses can be autoclaved. With all lenses the manufacturer's instructions for disinfection should be followed to prevent damage to the lens. 5 The Normal Angie The best preparation for recognizing angle pathology is to become familiar with the many variations of normal. Careful gonioscopic evaluation of the anterior segment fol lows a routine that evaluates all visible structures in a systematic fashion .

Most of the dark brown or black pigment p resent in the angle is intracellular, having been ingested through phagocytosis. Skin and hair color show lillie correlation with trabecular pigmentation (Scheie, I 957). There may be patchy areas or increased pigmentation over the circumference of the pigmented trabecular meshwork. These are located over aqueous collector channels and represent areas that have more outflow than the less pigmented areas. , 1984). Pigment in the angle is usually heaviest inferiorly owing to grav itational settling and aqueous circulation.

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