Demyelinating optic neuritis is inflammation of the optic nerve; it may be part of a clinically isolated syndrome (CIS) or associated with a systemic demyelinating disease. The clinical presentation and neuroimaging must exclude demyelinating diseases such as acute dissemina…

Trauma to the extraocular muscles will often result directly in specific ocular motility disorders that can pose a real challenge for treatment. Recent advances in orbital imaging, surgical techniques, and new information on different trauma mechanisms have improved the outc…

Leber congenital amaurosis (LCA) manifests itself in the first 6 months of life with significant visual loss and sensory, pendular nystagmus. Visual acuity (VA) in children with LCA varies significantly among patients with differing gene mutations; this variability has led i…

Patients with ND present with blindness due to leukocoria caused by immature retinal cell masses (pseudogliomas) and retinal detachments at birth. Treatment strategies include early laser photocoagulation or vitrectomy to prevent retinal detachment.

The purpose of gonioscopy is to permit visualization of the iridocorneal angle (or simply “angle”). Before exploring gonioscopic techniques and findings, it is important to review the anatomy and function of the structures of the angle.

Color Atlas of Gonioscopy, by Wallace L.M. Alward, MD, and Reid A. Longmuir, MD, is a brief, but comprehensive, introduction to gonioscopy. Gonioscopy is a visual science, so the greater part of the book is devoted to illustrations of gonioscopic and slit-lamp findings, norm…

Among the abnormalities associated with a closed angle are pupillary block, plateau iris, aqueous misdirection, and secondary pupillary block, Hyperopic eyes are at highest risk of angle closure; such eyes have shallow anterior chambers and small corneas.

While gonioscopy remains the gold standard by which the angle is evaluated, numerous anterior segment imaging techniques exist to assist in determining anterior segment structure. The two most commonly employed techniques are ultrasound biomicroscopy (UBM) and slit-lamp…

Viewing the anterior chamber of a normal eye directly is not possible. Light from the junction of the iris and cornea strikes the tear–air interface at a shallow angle, and it is totally reflected back into the eye; this is the principle of total internal reflection.

Primary infantile glaucoma results from failure of the angle to develop normally. The diagnosis of infantile glaucoma is usually made when parents notice photophobia with blepharospasm, tearing, cloudy corneas, or large eyes.