Your patient has shallow anterior chambers

The key question here is whether the patient is at risk of angle-closure glaucoma. Shallow anterior chambers are not uncommon and tend to occur in very long-sighted individuals, particularly those of Far Eastern ethnic origin.

Patients may be having episodes of intermittent angle closure without realising it. A typical history is intermittent eye ache associated with some blurring of vision occurring at night (when illumination is low and the pupil dilated). These episodes are relieved by bright light (causing pupil constriction and reversal of the angle blockage).

If the optometrist thinks the anterior chamber is so shallow that the angles are at risk of occluding, the patient should be referred for formal assessment. The referral may be routine but the patient should be warned about the signs and symptoms of acute angle-closure glaucoma (red, firm, painful eye, blurry vision, nausea). If they develop these symptoms, they should attend the emergency eye service immediately/urgently.