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In ophthalmology, gonioscopy is a routine procedure that measures the angle between the iris and the cornea (the iridocorneal angle), using a goniolens (also known as a gonioscope) together with a slit lamp or operating microscope. [1] [2] Its use is important in diagnosing and monitoring various eye conditions associated with glaucoma.
It should not however, be used as a replacement for the gonioscopy examination but rather be used as a means of refuting or confirming the results of a gonioscopy examination. [3] The Van Herick's technique has become the most commonly used qualitative method of assessing the size of the anterior chamber angle (ACA).
Sampaolesi line is a sign which may be observed during a clinical eye examination. During gonioscopy (where the structures of the eye's anterior segment are examined), if an abundance of brown pigment is seen at or anterior to Schwalbe's line, a Sampaolesi line is said to be present.
Gonioscopy of the anterior chamber angle. Labeled structures: 1. Schwalbe's line, 2. Trabecular meshwork (TM), 3. Scleral spur, 4. Ciliary body, 5. Iris Gonioscopy of the anterior chamber angle. Schwalbe's line is the anatomical line found on the interior surface of the eye's cornea, and delineates the outer limit of the corneal endothelium layer.
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Many cases are asymptomatic, however patients many have decreased vision, glare, monocular diplopia or polyopia, and noticeable iris changes. [2] [5] On exam patients have normal to decreased visual acuity, and a "beaten metal appearance" of the corneal endothelium, corneal edema, increased intraocular pressure, peripheral anterior synechiae, and iris changes.
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