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Ophthalmic presentation on Gonioscopy - A Simple overview

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srikanta panda
srikanta panda

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

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GONIOSCOPY Presented by Karan kumar Satapathy (40) Srikanta kumar Panda (85) Guided by Prof. Dr. Sujata Priyambada Madam
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
critical angle of cornea-air surface: 46尊
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
Ophthalmic presentation on Gonioscopy - A Simple overview
1 MIRRO R 2 MIRRORS 3 MIRROR S 4 MIRROR S
ANGLE STRUCTURE SEEN : Posterior Ciliary body band Scleral Spur Trabecular Meshwork Schwalbes line Anterior
Ophthalmic presentation on Gonioscopy - A Simple overview
GRADING Scheie system Based upon visibility of number of structures of the angle.
GRADING Shaffer system The Shaffer system is based on angularity. GRADE ANGLE CONFIGURATION STRUCTURES VISIBLE CHANCES OF CLOSURE IV 35尊-45尊 WIDEST ANGLE SL,TM,SS,CBB NIL III 25尊-35尊 OPEN ANGLE SL,TM,SS NIL II 20尊 MODERATELY OPEN SL,TM POSSIBLE I 10尊 VERY NARROW SL, anterior TM HIGHLY LIKELY 0 0尊 CLOSED NONE CLOSED
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
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Ophthalmic presentation on Gonioscopy - A Simple overview

  • 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: 46尊
  • 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
  • 7. ANGLE STRUCTURE SEEN : Posterior Ciliary body band Scleral Spur Trabecular Meshwork Schwalbes line Anterior
  • 9. GRADING Scheie system Based upon visibility of number of structures of the angle.
  • 10. GRADING Shaffer system The Shaffer system is based on angularity. GRADE ANGLE CONFIGURATION STRUCTURES VISIBLE CHANCES OF CLOSURE IV 35尊-45尊 WIDEST ANGLE SL,TM,SS,CBB NIL III 25尊-35尊 OPEN ANGLE SL,TM,SS NIL II 20尊 MODERATELY OPEN SL,TM POSSIBLE I 10尊 VERY NARROW SL, anterior TM HIGHLY LIKELY 0 0尊 CLOSED NONE CLOSED
  • 11. 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