The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.




Photo by Professor Chua Chung Nen

This 56 year-old man suffered from right acute angle closure glaucoma. Goniocopy showed peripheral anterior synechiae and the intraocular pressure could not be controlled with laser iridotomy. Trabeculectomy was performed and the intraocular pressure was lowered to 10 mmHg with only topical steroid.

Laser iridotomy may not be successful in acute angle closure glaucoma if the eye developed extensive peripheral anterior synechiae. The treatment of choice in such cases is trabeculectomy.


Fornix based trabeculectomy.




Slit-lamp view of glaucofleckens.

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