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Unless there is another factor involved such as a medication increasing IOP, for example steroids, or narrow anterior drainage angles, PDS must be kept at the forefront in terms of differential diagnosis.
However, there are other ocular manifestations in the different eye segments that are associated with aniridia, namely, from anterior to posterior, the cornea with dry eye and keratopathy, glaucoma and anomalies of the drainage angle of the eye, lens opacities and lens subluxation and retinal, and macular and optic nerve disorders associated with nystagmus.
This pushes forward the lens and the iris and blocks the drainage angle, causing an increase in the IOP (Kanski 2007).
Normally, the fluid flows out through the pupil and drains away through the sieve-like meshwork behind the drainage angle at the outer rim of the iris.
The crystalline lens is one of the few parts of the body that continues to grow throughout life, which results in narrowing of the drainage angle. For small hyperopic eyes this can lead to acute closed angle glaucoma (CAG) attacks, but in fact 50% of patients have CAG present for years with limited symptoms such as brow pain at twilight.
It is thought to be due to developmental abnormalities in the drainage angle of the eye, which obstruct the outflow of aqueous humor.
d) Increases outflow by opening the anterior drainage angle
If glaucoma is suspected, it's vital your visual fields are tested and the drainage angle, through which fluid drains out of the eye, is measured.