The association of iridoschisis and primary angle-closure glaucoma.

Twelve patients with iridoschisis in one or both eyes were studied to determine the clinical features of the condition and to examine the relationship of iridoschisis to primary angle-closure glaucoma. A spectrum of iris pathology, from subtle intrastromal atrophy to extensive splitting of the anterior layer of iris with fibrillar disintegration, was found in the affected and fellow eyes. Gonioscopy revealed partial or complete angle closure, particularly involving the superior angle, in all patients. Seven had glaucomatous disc damage and five had normal discs. The mean axial length and anterior chamber depth measurements in patients with iridoschisis were similar to those found in matched patients with primary angle-closure glaucoma but were significantly less than the measurements found in matched normals (p < 0.001). This study suggests that iridoschisis is an unusual manifestation of iris stromal atrophy and results from intermittent or acute elevation of intraocular pressure. Primary angle-closure glaucoma should be excluded in patients who present with iridoschisis.