To ZAP or not to ZAP?

A common incidental clinical finding among optometrists is ‘narrow angles'. That worryingly thin black space on Van Herick assessment alerts us to dust off our gonioscopy lens and perhaps look for some more benoxinate. Management would be straightforward if all the clinical signs showed an eye in trouble – obstructed angles, elevated intraocular pressure (IOP) and glaucomatous disc. But often the situation is much more nuanced. What we often find is only partially obstructed angles, normal pressures, and a healthy-looking nerve.