University of Iowa Health Care

Ophthalmology and Visual Sciences


Introduction - Indentation

Narrow Angle, Pupillary Block: This 60 year-old man has a strong family history of glaucoma. He was referred because his local optometrist found his iridocorneal angles to be narrow. He has mild hyperopia with a spherical equivalent of +0.75 OD and +1.25 OS. His intraocular pressures are normal at 12 mmHg OD and 15 mmHg OS. His optic nerve heads are completely normal.

Narrow Angles with Indentation Gonioscopy and Corneal Wedge: This 54 year-old woman was referred for narrow angles. She is mildly hyperopic (one diopter).

Pupillary Block (Indentation Gonioscopy): 64 year old woman with a one year history of glaucoma presents with narrow angles.

Narrow Angle False TM: This 41 year-old woman has angle closure. She had been treated in the right eye with trabeculectomy in the past and was lost to follow-up for three years. When she presented the intraocular pressure in this eye was 48 mmHg and her angles were closed to gonioscopy.

Indentation Gonioscopy with PAS: This 69 year old man has had open angle glaucoma for 17 years and has undergone Argon Laser Trabeculoplasty. He has a long history of pilocarpine use. At the time of presentation his intraocular pressures were 20 mmHg OD and 32 mmHg OS. Note: This video is also located in the Peripheral Anterior Synechiae category.

Pupillary Block - Narrow Angles PAS on Indentation: 80 year-old woman was found to have elevated IOP on routine examination at age 54. She was treated as a POAG patient. At age 77 she was found to have narrow angle with low PAS on indentation. She is hyperopic with a spherical equivalent of +3.25 D OU. Note: This video is also located in the Peripheral Anterior Synechiae category.

Plateau Iris Syndrome 1: 76 year-old woman with a history of narrow angles for which she had undergone iridotomies. She has mild hyperopia (+1.25 D OD and +1.00 D OS).

Plateau Iris Syndrome - Indentation: This 39 year-old patient is mildly hyperopic (+2 diopters OU). She had developed narrow iridocorneal angles and had undergone a laser iridotomy in both eyes. Following the iridotomy she continued to have narrow angles and plateau iris syndrome was diagnosed. This patient is included both under Techniques for Difficult Angles and Plateau Iris.

Indentation Broad PAS: This gentleman is moderately hyperopic patient (+1.00 diopters) who has had longstanding glaucoma. He was taking pilocarpine gel at the time that this video was taken. His intraocular pressure was 32 mmHg. On examination he has narrow angles with scattered peripheral anterior synechia that are seen on indentation. Note: This video is also located in the Pupillary Block and Peripheral Anterior Synechiae categories.

Plateau Iris Syndrome 2: In this video we see the indentation of a mildly hyperopic patient (+1.75 diopters). His iridocorneal angles were not felt to be occludable but in the on indentation one can see the peripheral role that is characteristic of plateau iris configuration.