Sihota et al identified risk factors for traumatic glaucoma occurring after a closed globe injury. These can help identify a patient who may benefit from more aggressive management. The authors are from the All India Institute of Medical Sciences in New Delhi.


Criteria for traumatic glaucoma:

(1) history of closed globe trauma

(2) raised intra-ocular pressure (>= 21 mm Hg)

(3) lasting >= 3 months


Risk factors associated with development of glaucoma:

(1) hyphema

(2) raised intra-ocular pressure at presentation after the ocular trauma

(3) angle recession > 180 degrees

(4) lens displacement

(5) pigmentation of the trabecular meshwork on gonioscopy Grade 3 (heavy) or Grade 4 (very heavy)

(6) large angle opening distance at 250 µm (on ultrasonographic biomicroscopy)

(7) wider distance from the scleral spur to the iris root

(8) absence of cyclodialysis cleft (the presence of a cleft is protective)


The risk of traumatic glaucoma increases as the number of risk factors increase.


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