We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Progressive Synechial Angle Closure From an Enlarging Soemmering Ring

Yungtai Kung, BS; Sung Chul Park, MD; Jeffrey M. Liebmann, MD; Robert Ritch, MD
Arch Ophthalmol. 2011;129(12):1631-1632. doi:10.1001/archophthalmol.2011.344.
Text Size: A A A
Published online


Angle closure in pseudophakic eyes is uncommon and its mechanism varies. Inflammation with posterior synechiae, zonular disruption with vitreous prolapse, and ciliary block with aqueous misdirection may predispose to angle closure and elevated intraocular pressure.

Proliferation of the remaining lenticular epithelial cells after cataract extraction may form a circumferential structure at the level of the lens (Soemmering ring). This typically benign structure has been reported to cause pupillary block, leading to angle closure.1 We describe a patient who had progressive synechial angle closure without pupillary block, due to an enlarging Soemmering ring after phacoemulsification.

Figures in this Article


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure. Ultrasound biomicroscopy images at the 6-o’clock (A) and 12-o’clock (B) positions taken 2 years earlier and at the 6-o’clock (C), 12-o’clock (D), 9-o’clock (E), and 3-o’clock (F) positions at presentation. The Soemmering ring (arrows) is shown as a hyperechoic ellipsoid structure (A and B) that is larger in the area of peripheral anterior synechiae (B). The Soemmering ring has enlarged compared with 2 years earlier (A and B vs C and D) with the progression of peripheral anterior synechiae (A vs C). E, Note the absence of a prominent Soemmering ring at the 9-o’clock position, where there are no peripheral anterior synechiae. G, Anterior segment optical coherence tomography reveals peripheral anterior synechiae at both sides of angles without iris bombé.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

4 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.