By Christoph Faschinger
Gonioscopy is an important differential diagnostic instrument that enables review of the anterior chamber perspective and proper class of glaucoma as a foundation for particular remedy. This booklet essentially explains find out how to practice gonioscopy to top impact. The anatomy of the chamber attitude is systematically defined, and the effect of age, developmental problems, and different pathologies at the chamber perspective is defined. specific awareness is targeted on fundamental and secondary open-angle and angle-closure glaucomas. In every one case, the position of gonioscopy in comparing the chamber perspective is defined with the aid of many photos and illustrations. the significance of data of the chamber perspective for laser remedy and surgical procedure is totally defined, and the impression of medicines is mentioned. The practitioner will locate in Gonioscopy all of the details required to take advantage of the method successfully in prognosis and treatment.
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Gonioscopy is an important differential diagnostic device that enables evaluate of the anterior chamber attitude and proper class of glaucoma as a foundation for particular remedy. This publication essentially explains find out how to practice gonioscopy to top influence. The anatomy of the chamber perspective is systematically defined, and the effect of age, developmental issues, and different pathologies at the chamber perspective is defined.
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Extra resources for Gonioscopy
6 Tumor Cells Etiology/pathomechanisms: Anterior segment tumors or disseminated tumor cells or tumorrelated inflammatory cells may obstruct parts of the trabecular meshwork. Chamber angle: Tumor masses or (mostly pigmented) tumor cells or inflammatory cells are found in the trabecular meshwork or the chamber angle. Fig. 14 Typical granulomatous nodules in the periphery of the iris, called Busacca nodules Fig. 15 Chamber angle of the same eye as shown in Fig. 7 After Ocular Trauma Etiology/pathomechanisms: Blunt trauma may cause tears in all structures of the chamber angle including detachment of the ciliary body.
In newborns and infants you need general anesthesia for appropriate examinations of the globe and the ocular structures. Take your time to do it as exactly as possible. Look closely and document well! 2 Examples of Genetic Disorders of the Anterior Segment 27 • Almost no or very little pigment of the trabecular meshwork. The surface glistens like cellophane. • Schwalbe’s ring and the scleral spur are not as white as in adults. • The recess is (much) smaller than in adults. • The peripheral anterior stroma of the iris is thin, and the pigmented layer shines through.
Over time – when accommodation is lost due to aging – most of the pigment has been released and the pigment dispersion or glaucoma has “burned out”. Then the pigmentation of the trabecular meshwork becomes less in the inferior part and more prominent in the superior half (“pigment reversal”). Fig. 5 Pigment on the anterior layer of the iris 42 Fig. 7 Pigment granules on the endothelial side of the cornea in a spindle-like shape (Krikenberg) Note: In a very concave configuration of the peripheral iris a reverse pupillary block exists and a peripheral iridotomy may be indicated.
Gonioscopy by Christoph Faschinger