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This situation can present acutely with an ‘angle closure’ type event (described above) or more insidiously. As one ages, the lens of the eye continues to grow and thicken. This reduces the space within the anterior chamber of the eye and can cause bowing forward of the iris and occlusion of the trabeculum (Fig. 2.2).

Treatment is focused on removing the cataractous lens once the intraocular pressure has been normalized medically. A peripheral iridotomy may be a temporizing measure, whilst waiting for surgery.