AC angle & depth assessment with Pen torch

Assessment of the anterior chamber angle (ACA) and ant erior chamber depth (ACD) is necessary for several reasons. Many types of glaucoma require ACA assessment for a correct diagnosis eg, narrow angle glaucoma, angle closure glaucoma, pigmentary glaucoma and neovascular (or 100- day) glaucoma. Visualisation of the angle is also recommended where there is any suspicion of peripheral anterior synechiae, angle recession or iridodialysis post-trauma. It is also useful for establishing the patency of peripheral iridotomies and a patient’s suitability for anterior chamber implants. In everyday practice it is useful to know the width of the angle to help determine the potential risk of angle closure prior to carrying out pupil dilation on a patient. This article describes the pentorch methods that can be used to assess the ACA and/or ACD in clinical practice.