Lens Induced Glaucomas

Change Language German

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‚Äôs Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)