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June 1971

Chronic Angle-Closure GlaucomaDiagnosis and Treatment in Patients With Angles That Appear Open

Author Affiliations

From the Glaucoma Service, the Wilmer Institute, Johns Hopkins University School of Medicine, Baltimore.

Arch Ophthalmol. 1971;85(6):676-689. doi:10.1001/archopht.1971.00990050678006

Twelve persons with asymptomatic chronic glaucoma and extremely narrow anterior chamber angles that appeared open were treated successfully with peripheral iridectomy. In each case initial examination revealed that there were no symptoms of angle closure and the clinical picture strongly resembled chronic (simple) open-angle glaucoma; intraocular pressure was elevated and frequently aggravated by medical therapy; there were large fluctuations in intraocular pressure; the angle was open to a slit or grade 1, except in one case with partial angle closure; and the mydriatic provocative test was negative. The natural course in this disease is for the chamber angle to become progressively narrowed with eventual appositional closure and later formation of peripheral anterior synechias. If the disease process is interrupted before formation of synechias, then the glaucoma is cured or can be controlled easily.