THE DETECTION OF POSTTRAUMATIC ANGLE-RECESSION BY GONIOSCOPY IN A POPULATION-BASED GLAUCOMA SURVEY

Background: Blunt trauma is responsible for most eye injuries in urban populations. Anterior chamber angle recession has been reported to be the most common sign of previous blunt trauma to the eye. The cumulat ive lifetime prevalence of post-traumatic angle recession has not been reported previously, and the relation between angle recession and gla ucoma in a population-based setting is unknown. Methods: As part of a population-based glaucoma survey, gonioscopy was performed on 987 (82. 7%) of 1194 inhabitants of the village of Mamre, near Cape Town, South Africa, who were 40 years of age or older. Results: Some degree of an gle recession was identified in one eye of 60 people and in both eyes of 86 people. Men were affected more than three times as often as wome n in the fifth, sixth, and seventh decades. The cumulative lifetime pr evalence of angle recession in this community was 14.6%. The prevalenc e of glaucoma in people with angle recession was 5.5% (8/146). Of 87 e yes with 360 degrees of angle recession, only 7 (8.0%) had glaucoma. E xcessive alcohol consumption was significantly related to the presence of angle recession in women (P < 0.001). The prevalence of monocular blindness due to trauma was 2.5% (25/987). Conclusion: Although the im portance of the study may be limited to this community, the findings s uggest that future population-based studies of ocular trauma should in clude gonioscopy on all individuals examined. Secondary glaucomas, esp ecially those related to trauma, should be screened for in developing countries when trying to establish the prevalence of potential visual loss from glaucoma.