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Phacolytic Glaucoma
Definition / Aetiology
- = Lens protein glaucoma
- Secondary open-angle glaucoma observed in association with a hypermature cataract. It involves obstruction of the trabecular meshwork by high molecular weight lens proteins, which leak from the intact capsule into the aqueous humour.
Clinical Presentation
- Pain, hypermature cataract, corneal oedema, +/- floating white particles in the aqueous humour, and potentially a pseudohypopyon, deep anterior chamber
Treatment
- Lower intraocular pressure (IOP), followed by cataract surgery
Phacomorphic Glaucoma
Definition/ Aetiology
- An acute secondary angle-closure glaucoma triggered by an intumescent lens
Clinical Presentation
- Shallow anterior chamber, moderately dilated pupil.
Treatment
- Lowering of intraocular pressure, possibly systemically with Diamox or Mannitol
- Miotics are not recommended as they can exacerbate the apposition of the iris to the lens and push the lens forward
- Consider iridotomy
- Early cataract surgery is advised
Sources
- EyeWiki Lens Induced Glaucomas
- The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)
- Kanski’s Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)