Current concepts in the treatment of vitreous block, also known as aqueous misdirection

Abstract

Vitreous block (VB), a rare secondary angle-closure caused by anterior rotation of the ciliary body, occurs in a variety of settings, but most frequently after glaucoma filtering surgery. The etiology remains unclear, but choroidal expansion and anterior vitreous abnormalities have been proposed. In the past, treatment of VB has yielded high rates of failure and recurrence. Advancements in surgical techniques, however, have led to improved visual outcomes. We review the history of this condition and present a stepwise approach to its diagnosis and treatment using modern imaging modalities and surgical techniques.

Keywords: aqueous misdirection; ciliolenticular block; ciliovitreal block; malignant glaucoma; secondary angle-closure glaucoma; vitreous block.