Contusion‐angle Deformity, Its Incidence and Appearance

Abstract

In 1962, Wolff and Zimmerman (10) gave a detailed description of the histopathological picture of the deformation of the chamber angle which may occur after ocular contusion.The lesion consists of a tear in the ciliary body resulting in a split between the circular and longitudinal fibres of the ciliary muscle. The latter retain their attachment to the scleral spur, while the former fibres, together with the root of the iris, are displaced backwards, giving rise to a recession of the chamber angle: which is characteristic of the lesion. In many cases, atrophy of the circular muscle fibres and fibrosis and hyalinisation of the trabecular meshwork occur, accompanied by variable obliteration of the intertrabecular spaces and the canal of Schlemm. A new-formed hyaIine membrane often covers the trabecular meshwork and continues centrally into the membrane of Descemet, while it extends into the deepened chamber angle peripherally. These changes may lead to a type of secondary monocular glaucoma of insidious onset which develops a long time after the immediate effects of the contusion have disappeared when the trauma may have been forgotten.In 1944, Rcese (7) described this hyaline membrane and its significance in the pathogenesis of glaucoma. He assumed that the development of the membrane was due to either inflammation or trauma, or to a primary disease. In 1949, D'Ombrain (4) described the traumatic, monocular chronic glaucoma; like Reese, he assumed that its occurrence was referable to the aforementioned hyaline membrane.The first description of the pathological anatomy of the lesion was given in ") Recieved March 28th 1966. 51