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Gonioscopy

Eye Care estimated about CNY 150-300

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Description

A diagnostic procedure using a gonioscope to examine the anterior chamber angle of the eye, assessing structures like the trabecular meshwork and iris root for glaucoma evaluation and other angle-related pathologies.

Main Uses

Primary clinical uses include: (1) diagnosing and classifying types of glaucoma (especially angle-closure vs. open-angle); (2) evaluating angle anatomy prior to laser or surgical interventions (e.g., laser peripheral iridotomy, goniosynechialysis); (3) detecting secondary angle abnormalities (e.g., neovascularization, pigment dispersion, pseudoexfoliation, trauma-related recession or synechiae); (4) monitoring angle changes over time in at-risk patients; and (5) guiding management decisions in acute angle-closure attacks or chronic angle disease.

Normal Range

Gonioscopy is a qualitative, non-quantitative imaging assessment; it does not yield numerical values or reference ranges. Instead, normal findings are described as: open anterior chamber angle with visible structures including Schwalbe’s line, trabecular meshwork, scleral spur, and ciliary body band — all without peripheral anterior synechiae (PAS), angle closure, neovascularization, or abnormal pigmentation. The Shaffer grading system (0–4+) is commonly used descriptively: Grade 4+ = wide open angle (>45°), Grade 3+ = ~30–45°, Grade 2+ = ~20–30°, Grade 1+ = ~10–20°, Grade 0 = closed angle.

Low Values - Possible Causes

Angle narrowing or closure due to pupillary block (e.g., in primary angle-closure glaucoma), plateau iris configuration, lens-induced angle closure (phacomorphic glaucoma), malignant glaucoma (ciliary block), or post-traumatic angle recession with synechial closure.

High Values - Possible Causes

Wide-open angles are typically physiological and not pathologically 'high'; however, abnormally wide angles may be associated with conditions such as high myopia (posterior scleral ectasia), Ehlers-Danlos syndrome (zonular laxity and shallow anterior chamber), Marfan syndrome (ectopia lentis and angle deepening), or prior iridectomy/iridotomy (artificial angle widening). Note: Gonioscopy does not produce 'high' numeric values — this refers to anatomically wider-than-typical angles.

gonioscopy anterior chamber angle assessment glaucoma diagnostic test eye pressure angle evaluation Shaffer gonioscopy grading

estimated about CNY 150-300