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October 1957

Width and Pigmentation of the Angle of the Anterior Chamber: A System of Grading by Gonioscopy

Author Affiliations

From the Department of Ophthalmology, Hospital of the University of Pennsylvania, and the Children's Hospital of Philadelphia.

AMA Arch Ophthalmol. 1957;58(4):510-512. doi:10.1001/archopht.1957.00940010526005

This paper presents methods for grading, by gonioscopy, (1) width and (2) degree of pigmentation of the angle of the anterior chamber. A moderate amount of experience permits accurate evaluation of both angle width and degree of pigmentation and lends objectivity to gonioscopic records otherwise difficult to achieve. The same or different observers, familiar with this classification, can accurately duplicate their findings.

A system of grading width of the angle of the anterior chamber is of considerable importance in the diagnosis and management of patients with glaucoma, especially of the primary type. Although gonioscopy by itself has limited diagnostic value in chronic simple glaucoma, one can be certain that if the angle is gonioscopically open and the tension is elevated the disease must be chronic simple in type. If the angle is extremely narrow, exhaustive diagnostic tests may be required to differentiate between chronic simple and narrow-angle glaucoma. Knowing the

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