Gonioscopy of a patient shows peripheral anterior synechiae (PAS) at the level of the anterior trabecular meshwork. The remaining angle shows a closed recess with appositional closure on dynamic indentation gonioscopy. According to the ISGEO classification, this is best categorised as:

• A Primary angle closure (PAC) ✓
• B Primary angle-closure suspect (PACS)
• C Primary angle-closure glaucoma (PACG)
• D Normal tension glaucoma

Explanation

ISGEO classification: PACS = occludable angle (iridotrabecular contact in ≥ 180°) but no PAS, no raised IOP, no optic disc damage; PAC = occludable angle PLUS PAS or raised IOP but NO optic disc/visual field damage; PACG = PAC PLUS glaucomatous optic neuropathy and/or visual field defects. The presence of PAS with appositional closure but no mentioned disc damage or VF loss classifies this as PAC.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.