Separation between the longitudinal and circular muscle of the ciliary body (commonly caused by blunt injury to the eye)
Incidence of intraocular pressure elevation appears to be directly related to the extent of angle involvement (may require at least 180 or 270 degree involvement)
Clinical Features
Symptoms:
May be asymptomatic
In the acute phase following injury, early onset glaucoma may be related to concurrent uveitis or hyphema
Signs:
Intraocular pressure may remain normal for years or decades before becoming elevated
Associated findings may include corneal edema, pupillary sphincter tear, subluxated lens, or hyphema
Gonioscopic examination may demonstrate:
The classic finding of a widened ciliary body band
Posterior iris displacement
Baring of the ciliary processes
Management
Routine follow-up of patient with recessed angle but no IOP elevation
Topical steroid therapy may be used with early post-traumatic IOP elevation believed secondary to increased outflow resistance from trabecular edema and inflammation
Anti-glaucoma medications such as aqueous suppressants (e.g. beta adrenergic antagonists), alpha2 adrenergic agonist, and miotics may be given
Surgical treatment (e.g. glaucoma filtration surgery) may be indicated for glaucoma unresponsive to medical therapy