Peripheral iridectomy is indicated in-a) Acute angle closure glaucoma b) Open angle glaucomac) Malignant glaucomad) In ICCEe) Pupil block glaucoma
**Core Concept**
Peripheral iridectomy, also known as iridotomy, is a surgical procedure where a small hole is created in the iris to improve the drainage of aqueous humor and relieve pressure in the eye. This procedure is typically performed to treat conditions that cause increased intraocular pressure (IOP).
**Why the Correct Answer is Right**
Peripheral iridectomy is specifically indicated in conditions where the drainage of aqueous humor is impeded, such as in pupil block glaucoma. In this condition, the iris blocks the trabecular meshwork, leading to increased IOP. By creating a hole in the iris, the aqueous humor can flow more freely, reducing IOP and alleviating symptoms. The procedure is also effective in conditions where the pupil is dilated, such as in acute angle closure glaucoma. However, the primary indication is for pupil block glaucoma.
**Why Each Wrong Option is Incorrect**
**Option A:** Acute angle closure glaucoma is a medical emergency that requires immediate treatment with medications to reduce IOP. While peripheral iridectomy may be performed in some cases, it is not the primary indication for this procedure.
**Option B:** Open angle glaucoma is a condition where the drainage channels in the eye are open, but the trabecular meshwork is clogged, leading to increased IOP. Peripheral iridectomy is not indicated in open angle glaucoma, as the problem lies in the trabecular meshwork, not in the iris.
**Option C:** Malignant glaucoma is a rare condition characterized by a shallow anterior chamber and increased IOP. Peripheral iridectomy is not the primary treatment for malignant glaucoma, which often requires medical treatment with medications to reduce IOP and deep the anterior chamber.
**Option D:** In ICCE (Intracapsular cataract extraction), a peripheral iridectomy is performed to prevent postoperative glaucoma. However, this is not the primary indication for peripheral iridectomy, as it is a secondary prevention measure.
**Clinical Pearl / High-Yield Fact**
Peripheral iridectomy is a crucial procedure in the management of glaucoma, particularly in cases of pupil block glaucoma. It is essential to remember that peripheral iridectomy is not a substitute for medical treatment in acute angle closure glaucoma, but rather a complementary procedure to alleviate symptoms.
**Correct Answer: E. Pupil block glaucoma**