Purpose of review
To summarize the multiple mechanisms responsible for
angle closure in
uveitis and to outline the management principles and treatment modalities.
Recent findings
Angle closure in
uveitis is a heterogeneous disease with multiple mechanisms. Recent advances in
anterior segment imaging have provided insights into the mechanisms of
angle closure in
uveitis. Uveitic eyes with
angle closure from pupil block require surgical iridectomy with mobilization of the peripheral iris and viscogoniosynechiolysis of both posterior synechiae and peripheral anterior synechiae. Systemic conditions associated with
uveitis can result in anterior displacement of the iris–lens diaphragm, and present as acute
angle closure. Pupil block is not the predominant mechanism in these eyes, and management is primarily medical. Data are limited on the optimal treatment of
angle closure in
uveitis, and the role of glaucoma filtration surgery, cataract extraction, minimally invasive glaucoma surgery and newer modalities of cycloablation require evaluation.
Summary
The management of
angle closure in
uveitis should adhere to the principles of managing both uveitic glaucoma and
angle closure. Identification of the mechanism of
angle closure in uveitic eyes may enable treatment to be targeted at the responsible mechanism.
