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

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



Glaucomflecken in primary acute angle closure glaucoma

Photo by Dr. Ngo Chek Tung

A 60 year-old woman complained of a one-week history of painful left eye and decreased vision. She was found to have an intraocular pressure of 65 mmHg, shallow anterior chamber and semi-dilated pupil. The pressure was controlled with oral acetazolamide and topical pilocarpine and timolol. The following pictures show glaucomflecken (due to ischaemic anterior lenticular epithelium) and closed trabecular meshwork angle on gonioscopy.


Glaucomflecken and pigment on the anterior lens surface.


Glaucomflecken, shallow anterior chamber and corneal oedema.


Closed angle of the trabecular meshwork on gonioscopy.

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