Abstract

Secondary angle closure glaucoma (SACG) can be quite puzzling and can challenge even an experienced glaucoma surgeon. Unlike primary angle closure glaucoma, SACG can have various ocular and systemic associations. A careful review of the symptoms, past ocular and surgical history cannot be overemphasized. Some of the SACG can be refractory requiring drainage devices. But, sometimes all it takes is a prompt laser iridotomy. This can significantly reduce ocular morbidity and in some situations, even blindness. Gonioscopy, often an underutilized technique, is critical in making the right diagnosis. With the advent of imaging techniques like anterior segment optical coherence tomography and ultrasound biomicroscopy, one can easily pick up the etiology and treat early. As many of the SACG present acutely, it is critical that one makes a prompt diagnosis. We present here a video bouquet of illustrated examples of SACG and the steps to identify the cause with different imaging techniques.