Abstract
We appreciate the comments from Dr Eke regarding our paper on corneal indentation in the early management of acute angle closure.1Masselos K. Bank A. Francis I.C. Stapleton F. Corneal indentation in the early management of acute angle closure.Ophthalmology. 2009; 116: 25-29Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar It is interesting to note that Dr Eke has also been using the technique of corneal indentation since the mid-1990s.We agreed with many of Dr Eke's comments. In particular, Dr Eke introduced the term finger-tip corneal indentation. This appears to be a useful and interesting method of treating acute angle closure. If this were successful, it would be an even simpler technique to teach and could be of great benefit to those in rural and remote areas. We also agree that using a gonioprism to localize areas of the angle that are free of synechiae is a useful exercise; however, we feel this is not essential particularly with finger-tip corneal indentation.With regards to the use of a cotton tip, we generally use the inferior cornea for indentation in order to preserve the superior corneal epithelium as we suggested in our paper. This permits a clear view of the iris for a subsequent laser peripheral iridotomy.We are hopeful that other readers will also find this technique valuable and will consequently use corneal indentation as an immediate first-line treatment for acute angle closure. We appreciate the comments from Dr Eke regarding our paper on corneal indentation in the early management of acute angle closure.1Masselos K. Bank A. Francis I.C. Stapleton F. Corneal indentation in the early management of acute angle closure.Ophthalmology. 2009; 116: 25-29Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar It is interesting to note that Dr Eke has also been using the technique of corneal indentation since the mid-1990s. We agreed with many of Dr Eke's comments. In particular, Dr Eke introduced the term finger-tip corneal indentation. This appears to be a useful and interesting method of treating acute angle closure. If this were successful, it would be an even simpler technique to teach and could be of great benefit to those in rural and remote areas. We also agree that using a gonioprism to localize areas of the angle that are free of synechiae is a useful exercise; however, we feel this is not essential particularly with finger-tip corneal indentation. With regards to the use of a cotton tip, we generally use the inferior cornea for indentation in order to preserve the superior corneal epithelium as we suggested in our paper. This permits a clear view of the iris for a subsequent laser peripheral iridotomy. We are hopeful that other readers will also find this technique valuable and will consequently use corneal indentation as an immediate first-line treatment for acute angle closure. Angle Closure GlaucomaOphthalmologyVol. 116Issue 7PreviewI congratulate Masselos et al on their article entitled, “Corneal indentation in the early management of acute angle closure,”1 which I hope will serve to popularize this technique. I have been using corneal indentation (CI) since the mid-1990s, with a similarly high success rate. I wholeheartedly agree that CI can be highly effective in the initial management of acute angle closure (AAC), giving a rapid resolution of the initial AAC attack without the need for eye drops, tablets, or injections. Full-Text PDF
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