Axenfeld anomaly is a developmental condition of the front of the eye in which the line marking the junction between the cornea and the trabecular meshwork is displaced forwards and connected to the iris by strands of tissue. It forms part of the anterior segment dysgenesis spectrum.
Features
Typical findings include a prominent or displaced Schwalbe line, often visible as a ring on gonioscopy, and fine iris processes that bridge to the angle. The cornea is usually clear, and visual acuity may be normal unless other abnormalities are present.
- Often affects both eyes, though asymmetry is common
- Can be isolated or associated with other anterior segment changes
- May be inherited in an autosomal dominant pattern
- Some individuals remain asymptomatic and are diagnosed only on examination
Glaucoma Risk and Management
Axenfeld anomaly carries an increased risk of glaucoma because the drainage angle can be structurally abnormal. Long-term follow-up is recommended to monitor intraocular pressure and optic nerve appearance.
- Regular pressure checks and visual field tests help detect early glaucoma
- Treatment follows standard glaucoma approaches if pressure rises
- Family members may require examination because of possible inheritance
- Careful documentation of angle anatomy guides future management
