2020–2021 BCSC Basic and Clinical Science Course™
4 Ophthalmic Pathology and Intraocular Tumors
Part I: Ophthalmic Pathology
Chapter 7: Anterior Chamber and Trabecular Meshwork
See BCSC Section 10, Glaucoma, for additional discussion on the conditions described in the following sections.
Figure 7-3 Congenital glaucoma. This histologic example of a “fetal” anterior chamber angle demonstrates the anterior insertion of the iris root (red arrow), the anteriorly displaced ciliary processes, and a poorly developed scleral spur (black arrow) and trabecular meshwork (arrowhead).
(Courtesy of Tatyana Milman, MD.)
Primary Congenital Glaucoma
Primary congenital glaucoma (PCG), also referred to as congenital or infantile glaucoma, can be evident at birth or become evident within the first few years of life. The pathogenesis of PCG is likely related to arrested development of the anterior chamber angle structures. Histologically, the anterior chamber angle retains an “embryonic” or “fetal” conformation, characterized by the following:
anterior insertion of the iris root
mesenchymal tissue in the anterior chamber angle
poorly developed scleral spur, allowing the ciliary muscle to insert directly into the trabecular meshwork (Fig 7-3)
See BCSC Section 6, Pediatric Ophthalmology and Strabismus, and Section 10, Glaucoma, for detailed discussion of PCG.
Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.