Gonioscopy – a closer look at the angle

One of the first challenges of my glaucoma fellowship was mastering gonioscopy and the iridocorneal angle. As you know, there are many indications for performing gonioscopy, including patients potentially at risk for angle closure, determining the cause of intraocular pressure (IOP) elevation in various acute and chronic settings, trauma and examining abnormalities of the iris or iris lesions. Unfortunately, gonioscopy seems underutilised in routine clinical practice¹. Not only are there a multitude of anatomical variations from patient to patient, but the procedure can prove challenging on select patients. I’ll share some key pearls gleaned from mentors in my attempts to master the iridocorneal angle.