Secondary Angle-Closure Glaucoma

Secondary angle closure refers to a myriad of disorders with non-pupillary block mechanisms that can be either anterior pulling or posterior pushing. Several mechanisms of angle closure have been described and can coexist in a single eye. Precise identification of the specific pathogenesis is essential in the management of secondary angle closure. The success of medical treatment and surgical intervention is a direct reflection of the underlying etiology. Dark room indentation gonioscopy, biometry, and modern imaging with ultrasonography (UBM) and anterior segment optical coherence tomography (AS-OCT) are essential in making accurate diagnoses which allows for definitive treatment and successful outcomes. Since the trabecular meshwork in secondary angle closure is intrinsically normal, it is possible to restore the trabecular function by early removal of the synechiae before irreversible ultrastructural changes have occurred.