Case Report: Getting a Peek at the Angle of a Patient with Severe Keratoconus

Rumi Kawashima,Naoyuki Maeda,Kenji Matsushita,Kohji Nishida,Kazuhiko Ohnuma,Shizuka Koh

doi:10.3389/fopht.2022.843224

Abstract

Visualization of the iridocorneal angle, which contains the aqueous humor circulatory system and controls intraocular pressure, is important for diagnosing and managing glaucoma; however, the presence of keratoconus, keratoglobus, or severe myopia may enable direct angle visualization without gonioscopy contact lenses or applying a coupling gel. We present the first report of a case in which the iridocorneal angle was viewed directly in an eye with keratoconus using the RetCam without applying gel to the cornea. This method overcame the inability to view the angle directly in a normal eye because of the total internal reflection.

Highlights

Reviewed by: Shi Song Rong, Massachusetts Eye & Ear Infirmary and Harvard Medical School, United States Eray Atalay, Eskisehir Osmangazi University, Turkey
We present the first report of a case in which the iridocorneal angle was viewed directly in an eye with keratoconus using the RetCam without applying gel to the cornea
Ultrasound biomicroscopy (UBM) can visualize structures of the iridocorneal angle and ciliary body in more detail; the transducer must be in contact with the eye, which induces patient discomfort, and the examiner must be experienced

Summary

Introduction

Reviewed by: Shi Song Rong, Massachusetts Eye & Ear Infirmary and Harvard Medical School, United States Eray Atalay, Eskisehir Osmangazi University, Turkey. Visualization of the iridocorneal angle, which contains the aqueous humor circulatory system and controls intraocular pressure, is important for diagnosing and managing glaucoma; the presence of keratoconus, keratoglobus, or severe myopia may enable direct angle visualization without gonioscopy contact lenses or applying a coupling gel. We present the first report of a case in which the iridocorneal angle was viewed directly in an eye with keratoconus using the RetCam without applying gel to the cornea.

Results

Conclusion