Gonioscopy: Why do indentation?

Abstract

Examination of the iridocorneal angle is an essential part of a complete ophthalmic examination, but a busy practitioner will not put a goniolens on every new patient. So, which patients should be examined? Glaucoma-related reasons to do gonioscopy include: identification of eyes at risk for angle-closure; evaluation of the extent of known angle-closure evaluation of the angle of any eye at risk for a secondary glaucoma: pseudoexfoliation, pigmentary dispersion, uveitis, past history of contusion, retinal vein occlusion, diabetes, etc.; treatment of the angle by laser: trabeculoplasty, iridoplasty, goniopuncture; verification of patency of a trabeculectomy, and, last but not least, learning the anatomy of the normal angle. Gonioscopy should be done routinely in cooperative patients when time permits to learn the variations in normal angles (Figs. 14.1 and 14.2). If a lens is only put on eyes with narrow angles it will be more difficult to distinguish normal from the pathologic. © 2010 Springer-Verlag Berlin Heidelberg.