A 26-year-old man who suffered a traumatic hyphema one year ago now presents with raised intraocular pressure in the injured eye. Gonioscopy reveals a widening of the ciliary body band with an abnormally deep angle recess over more than 180 degrees. The mechanism of his glaucoma is:
- A Dislocation of the crystalline lens into the anterior chamber
- B Neovascularisation of the angle with fibrovascular membrane formation
- C Tear between the circular and longitudinal fibres of the ciliary muscle leading to trabecular dysfunction ✓
- D Epithelial ingrowth through a self-sealing wound
Correct answer: C. Tear between the circular and longitudinal fibres of the ciliary muscle leading to trabecular dysfunction
Explanation
Angle recession is a tear between the circular and longitudinal fibres of the ciliary body, producing a characteristically widened ciliary body band on gonioscopy. Secondary open-angle glaucoma develops in a proportion of eyes, and the risk rises sharply when more than 180 degrees of the angle is involved, often appearing months to years after the original hyphema. Neovascular glaucoma shows vessels and peripheral anterior synechiae, not a recessed angle.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.