Phacolytic Glaucoma

• A form of lens-induced open-angle glaucoma.
• Caused by the leakage of lens protein (from a mature or hypermature cataract) into the aqueous humor, thereby causing obstruction of aqueous outflow.

Clinical Features

• Symptoms: may present as sudden or insidious onset of ocular pain and worsened vision
• Signs:
  • Occurs unilaterally (majority of cases)
  • Conjunctival hyperemia (associated)
  • Acutely elevated intraocular pressure (may reach as high as 80 mmHg)
  • Diffuse corneal edema
  • Inflammatory cells in the anterior chamber
  • Presence of white patches on the anterior lens capsule probably representing phagocytosis of lens protein by macrophages
  • On gonioscopy evaluation, the anterior chamber angle appears open

Management

• Anti-inflammatory therapy
• Anti-glaucoma medication(s)
• Cataract removal surgery (the IOP usually returns to normal in several days)