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15. Holmberg AS. Schlemm’s canal and the trabecular meshwork. An electron microscopic study of the normal structures in man and monkey (Cereopithecus ethops). Doc Ophthalmol 1965; 19:339–373. 16. Barishak YR. The development of the angle of the anterior chamber in vertebrate eyes. Doc Ophthalmol 1978; 45:329–360. 17. Sampaolesi R, Zarate JO, Caruso R. Congenital glaucoma light and scanning electron microscopy of trabeculectomy specimens. In: Leydhecker W, Krieglstein GK, eds. International Glaucoma Symposium, Nara, Japan, 1978: Glaucoma Update.

The older and more cooperative the child, the more detailed the examination. By the age of 8 to 10 years, most children can cooperate for a full quantitative visual field examination. 8 A mild sedative such as chloral hydrate can allow complete examination, and avoid deep anesthesia (examination under anesthesia) requiring respiratory support. This child’s anterior segment and anterior chamber angle is examined using Koeppe gonioscopy. The diagnostic examination A reasonably good office examination can sometimes be performed in infants younger than 3 months of age using the infant diagnostic lens of Richardson–Shaffer or a small diameter Koeppe lens.

Note the high insertion of the iris. There is no definite visible scleral spur. ’41 Sometimes exposure of the radial iris vessels may exist in normal blue-eyed infants or in the eyes with hypoplasia of the anterior iris stroma. 42 Ophthalmoscopy Evaluation of the optic disc is an essential part of the examination. Ophthalmoscopy under general anesthesia is most easily performed through a semi-dilated pupil (Fig. 12). 5% phenyl- ephrine and 1% cyclopentolate. 43 If surgery is contemplated, ophthalmoscopy should be done without dilatation.

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