A CASE REPORT: ANGLE RECESSION AFTER OCULAR BLUNT TRAUMA.

To report a case of angle recession in a patient after blunt ocular trauma and to describe the imaging tools employed to diagnose and follow up the patient. 

 

The patient was first attended in August 2020 in Clinica Oftalmológica Antonio Moreno in Málaga. 

 

We describe a case of a 27-year-old patient who consulted in our clinic after a blunt ocular trauma. He complained of vision loss and pain in the affected eye. At exploration he had a BCVA of 0.6, a 1/10 of anterior chamber volume hyphema and the rest of the slit lamp examination was normal. A gonioscopy was performed and it revealed a widening of the ciliary body band in more than 180º of the angle asymmetric with the fellow eye. The IOP was normal and treatment with oral and topical corticoids an cycloplegic was initiated. 

Usually, the diagnosis of angle recession is based on gonioscopy or ultrasound biomicroscopy findings. These examination methods, however, entail the direct contact of the device with the eye, which can increase the risk of corneal damage and infection. In this case, in addition to the gonioscopy, we used an SS-OCT to obtain the images of the anterior segment and we observed the angle recession in the eye that suffered the traumatism. 

 

At 2 weeks follow up we observed the disappearance of the hyphema and no increase in the IOP. The images of the anterior segment still reveal the recession with no improvement in comparison with the first visit. The patient has regular follow-up to control of the IOP. 

 

In these patients, it is important to diagnose the risk factors for traumatic glaucoma. New technology such as anterior segment SS OCT improves and facilitates the assessment in these cases. The patients should be adequately counselled and follow-up examinations should be performed regularly. The follow-up depends on the degree of IOP control