An Atlas of Gonioscopy http://www.gonioscopy.org http://webeye.ophth.uiowa.edu/Gonioscopy/ICE.html This is a 43 year-old with unilateral glaucoma with an intraocular pressure to 15 mmHg and a history of a failed trabeculectomy. A great example of the endothelial changes on slit lamp examination. Courtesy of Young H. Kwon, M.D., Ph.D., The University of Iowa http://webeye.ophth.uiowa.edu/Gonioscopy/ICE.html At 35 years old was diagnosed with both pigment dispersion OD and essential iris atrophy OS. Her essential iris atrophy prevented her development of PDS OS. http://webeye.ophth.uiowa.edu/Gonioscopy/postSurgAppear.html This patient at age 83 presented with hyphema in the left eye. He had undergone a trabeculectomy a decade earlier and had a phacoemulsification about 6-years earlier. One can see bleeding from the trabeculectomy site. Attempts at laser coagulation were unsuccessful but a surgical revision of the bleb resolved this patients intermittent bleeding episodes. Courtesy of Young H. Kwon, MD, PhD. The University of Iowa. http://webeye.ophth.uiowa.edu/Gonioscopy/postSurgAppear.html This patient has primary open angle glaucoma. At age 50 he underwent a trabeculectomy in his right eye and, 7 months later had a needling performed of the bleb. After the bleb needling he was referred in with the clinical appearance seen here. His iris is peaked and there is pigmented material inside the filtering bleb. Thankfully, his intraocular pressure was 9 mmHg and his visual acuity was 20/25. Courtesy of Young H. Kwon, M.D., Ph.D., The University of Iowa. http://webeye.ophth.uiowa.edu/Gonioscopy/postSurgAppear.html This patient had iris to a sclerostomy after trabeculectomy. The video shows the appearance before and after Nd:YAG laser treatment to open the sclerostomy site. http://webeye.ophth.uiowa.edu/Gonioscopy/postSurgAppear.html At age 31 this 35 year old Asian-American woman underwent nonpenetrating glaucoma surgery while visiting Japan. She had a history of normal tension glaucoma. At the time she was seen she was on three classes of medications in each eye with intraocular pressures of 10 mmHg OD and 11 mmHg OS. http://webeye.ophth.uiowa.edu/Gonioscopy/congenitalGlauc.html This 17 year old had been diagnosed with primary congenital glaucoma at age 4 months. He underwent goniotomies in both eyes at age 5 months and a subsequent trabeculotomy in the right eye a year later. The left eye has IOP control on no medications and the right eye required the use of three medications. This patient is an excellent example of Haab striae and immature angle that one sees in primary congenital glaucoma. Courtesy of Young H. Kwon, M.D., Ph.D., The University of Iowa. http://webeye.ophth.uiowa.edu/Gonioscopy/pigmentary.html At 35 years old was diagnosed with both pigment dispersion OD and essential iris atrophy OS. Her essential iris atrophy prevented her development of PDS OS. http://webeye.ophth.uiowa.edu/Gonioscopy/phacolytic.html This 94 year old patient has a disciform scar in the right eye. He has had vision reduced to the level of light perception for 8 years at the time this video was taken. The right lens shows a hypermature cataract with loss of cortical substance and wrinkling of the anterior capsule. This is what a lens looks like when most of the cortex is gone. This patient never had a phacolytic reaction. http://webeye.ophth.uiowa.edu/Gonioscopy/miscellaneous.html This 78 year old woman with primary open angle glaucoma has been on chronic cholinergics. Her pupil fails to dilate when given cycloplegic/mydriatic drop due to fibrosis of the sphincter. However the peripheral iris does get thrown into folds by the attempt of dilation. http://webeye.ophth.uiowa.edu/Gonioscopy/miscellaneous.html This 37 year old was found to have a prominent iris vessel on his right iris during a routine examination. This vessel was found to be non-leaking on fluorescein angiography. This patient has arterial venous malformation of the iris. A series of 14 cases were published by Shields, et. al., in the Archives of Ophthalmology, Vol. 124, pp. 370-375, 2006. To quote Dr. Shields “Iris AV malformation has characteristic clinical and fluorescein angiographic features. It appears to be a benign stationary condition that has no apparent systemic associations and no local complications.” My thanks to the referring physicians: Kenneth C. Kubis, MD (CAPT, MC, USN - Department Head, Neuro-ophthalmology) and Andrew Doan, MD, PhD (LCDR, MC, USN - Comprehensive Ophthalmology & Ocular Pathology) Naval Medical Center San Diego http://webeye.ophth.uiowa.edu/Gonioscopy/tumor.html The iris lesion in this 79 year old patient developed rather suddenly. He had been followed in the same practice for 35 years and three years before this video had undergone cataract extraction with no mention of an iris abnormality. We see a large mass that has broken through the iris and a really nice example of the value infrared video transillumination to see the extent of this lesion posteriorly. This patient was returned to his home state for enucleation and an oncology evaluation. http://webeye.ophth.uiowa.edu/Gonioscopy/cyst.html On routine examination this 65 year-old female was found to have an area of fullness in the iris of her right eye. Here she was found to have multiple iris cysts in both eyes. http://webeye.ophth.uiowa.edu/Gonioscopy/uveitis.html This 30 year-old man was seen three days after new onset of anterior uveitis. He was begun on prednisolone every two hours and anti-viral therapy. After three days he developed fascinating precipitates with clear centers. He was determined to have herpes simplex virus. Fri, 22 Jan 2010 15:11:00 CST en-us