Purpose of review
To summarize the multiple mechanisms responsible for angle closure
and to outline the management principles and treatment modalities.
Recent findings Angle closure
is a heterogeneous disease with multiple mechanisms. Recent advances in anterior segment imaging
have provided insights into the mechanisms of angle closure
. 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
, and the role of glaucoma filtration surgery, cataract extraction, minimally invasive glaucoma surgery and newer modalities of cycloablation require evaluation.
The management of angle closure
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.