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Corner recession: causes, symptoms, diagnosis, treatment
Last reviewed: 08.07.2025
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Epidemiology of angle recession
Angle recession occurs with blunt or penetrating trauma to the anterior segment. The risk of developing glaucoma with angle recession is proportional to the extent of the damage to the ciliary body, with a frequency of 10% for ruptures greater than 180°. Glaucoma develops over a period of several months to several years after the injury. Patients with glaucoma with angle recession tend to develop open-angle glaucoma, as evidenced by the fact that up to 50% of such patients subsequently have elevated intraocular pressure in the second eye.
Pathophysiology of angle recession
Angle recession occurs when the connection between the circular and longitudinal muscle layers of the ciliary body is broken. Glaucoma with angle recession develops due to the disruption of the outflow of intraocular fluid. Direct damage to the trabecular meshwork or Descemet-like endothelial proliferation in the trabecular area leads to obstruction of the outflow pathway.
Symptoms of angle recession
Patients have a history of recent or old trauma to the affected eye. The disease may be asymptomatic or may present with pain, photophobia, and decreased vision due to increased intraocular pressure. Visual field defects or an afferent pupillary defect due to glaucomatous damage to the optic nerve are identified. In addition, damage to other ocular or orbital tissues may be detected during examination.
Diagnosis of angle recession
Biomicroscopy
Slit lamp examination reveals signs of previous trauma: scarring of the cornea or blood staining, cataracts, phacodenesis, ruptures of the iris sphincter or ruptures in the area of its root (iridodialysis).
Gonioscopy
Gonioscopy shows uneven expansion of the ciliary body band. Signs of torn ciliary processes or an increase in the elevation of the scleral spur may be seen. Normally, the ciliary body should be approximately uniform in size around the entire circumference, not as wide as the trabecular meshwork. Comparison with a healthy eye helps in making a diagnosis.
Posterior pole
At the posterior pole, there may be evidence of previous blunt or penetrating trauma: choroidal ruptures, retinal detachment, or vitreous hemorrhage. In addition, the affected eye shows asymmetry of optic disc excavation due to increased intraocular pressure.
Special tests
When examining the visual fields, scotomas of the glaucomatous type are detected.
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Treatment of angle recession
Patients with angle recession diagnosed after trauma by gonioscopy should be monitored closely for early glaucoma. Increased intraocular pressure is usually difficult to control. Initial treatment is with drugs that suppress aqueous secretion. Hyperosmotic agents are added if necessary. Miotics often worsen the condition in angle recession, as they reduce uveoscleral outflow in cases where intraocular pressure control depends on it. In patients with angle recession, the effectiveness of laser trabeculoplasty is limited, and gentle filtering surgery is often necessary to control intraocular pressure.