Ophthalmic presentation on Gonioscopy - A Simple overview

it's a presentation on gonioscopy which i presented in class. This is an overview on gonioscopy.

1. Gonioscopy Presented by Karan kumar Satapathy (40) Srikanta kumar Panda (85) Guided by Prof. Dr. Sujata Priyambada Madam

2. What is Gonioscopy? It is a biomicroscopic examination of angle of anterior chamber ( irido -corneal angle) by using a device goniolens / gonioscope/ gonioprism WHY the ANGLE OF ANTERIOR CHAMBER CANNOT BE VISUALISE DIRECTLY? Lack of transparency of corneoscleral junction. Emergent light from angle structures undergo Total Internal Reflection at Corneal surface

3. critical angle of cornea-air surface: 46º

4. Types: Direct gonioscopy: Done in supine position Provides a direct view of the angle Useful in bedridden patient, anaesthetized patient, children E.g., Koeppe goniolens , Barkan goniolens Indirect gonioscopy: Done in sitting position on slit lamp Provides a mirror image of the opposite angle E.g. Zeiss 4 mirror gonioscope, Posner 4 mirror gonioscope, Goldmann single mirror gonioscope

5. 1 MIRROR 2 MIRRORS 3 MIRRORS 4 MIRRORS

6. Angle structure seen : Posterior Ciliary body band Scleral Spur Trabecular Meshwork Schwalbe’s line Anterior

7. grading Scheie system Based upon visibility of number of structures of the angle .

8. grading Shaffer system The Shaffer system is based on angularity . GRADE ANGLE CONFIGURATION STRUCTURES VISIBLE CHANCES OF CLOSURE IV 35º-45º WIDEST ANGLE SL,TM,SS,CBB NIL III 25º-35º OPEN ANGLE SL,TM,SS NIL II 20º MODERATELY OPEN SL,TM POSSIBLE I 10º VERY NARROW SL, anterior TM HIGHLY LIKELY 0º CLOSED NONE CLOSED

9. Application of Gonioscopy: Classification of Glaucoma Localization of foreign bodies, abnormal blood vessels, tumors in angle Demonstration of Peripheral Anterior Synechiae Surgical aid in goniotomy Contraindication of Gonioscopy: Hyphaema Compromised cornea (e.g., corneal ulcer) Lacerated or perforated globe

10. Thank you