A 19-year-old presents two years after a cricket ball injury to the right eye. Intraocular pressure is now persistently 32 mmHg despite maximal topical therapy. Gonioscopy reveals a widening of the ciliary body band over more than two clock hours compared with the fellow eye. The mechanism of this secondary glaucoma is:

• A Neovascularisation of the angle
• B Ghost cell outflow obstruction
• C Forward displacement of the lens-iris diaphragm
• D Tear in the ciliary body allowing aqueous access to a collapsed trabecular meshwork ✓

Explanation

Angle recession is a tear between the longitudinal and circular fibres of the ciliary body, seen gonioscopically as an abnormally wide ciliary body band. Late glaucoma occurs in a subset of eyes because the damaged trabecular meshwork progressively fails, often years after trauma. Neovascular glaucoma shows new vessels, not a recessed angle, which distinguishes that distractor.

Reference: American Academy of Ophthalmology, BCSC Section 10: Glaucoma, 2022-2023 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.