Which pearls are paramount when managing glaucoma associated with ocular trauma?
Most important is that this common cause of unilateral glaucoma is often missed. Unfortunately, the signs of trauma that may be long past are oftentimes cryptic and hard to identify. I credit David Campbell, MD, of Hanover, New Hampshire, with giving a lot of thought to traumatic glaucoma. Damage to certain rings of tissue can herald the possible development of glaucoma in these eyes. For example, one should look for radial ruptures in the sphincter muscle, an iridodialysis or tears in the peripheral iris, and frank angle recession in the anterior ciliary body. Angle recession is not always just significant posterior displacement of the iris root. It can be a bare scleral spur, reduced uveal processes compared with other quadrants, or an asymmetry of the angle inlet compared with that of the contralateral eye. In addition, the surgeon should examine the attachment of the ciliary body to the scleral spur. Trauma may have produced a cyclodialysis cleft, which can sometimes be difficult t
