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Ophthalmology · Glaucoma: indentation gonioscopy
Sample itemOn static gonioscopy the angle of an eye appears closed. When the cornea is gently indented with a four-mirror lens, the iris falls back and the trabecular meshwork becomes visible. What does this show?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Appositional closure without peripheral anterior synechiae
Indentation pushes aqueous toward the angle periphery and opens an angle that is merely appositionally closed. If the iris stays stuck, synechial closure is present, which does not respond to iridotomy alone. The distinction guides whether laser or filtering surgery is needed.
Option by option
A. Angle recession
Angle recession shows a widened ciliary body band, not a closed angle.
B. Appositional closure without peripheral anterior synechiae (correct)
Correct. A closure that opens on indentation is appositional, not synechial.
C. Permanent synechial closure
Synechiae do not release with indentation.
D. Neovascularisation of the angle
New vessels would be seen crossing the scleral spur, not an opening on indentation.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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