Pupillary Block

Dislocation of a posterior chamber intraocular lens resulting in the formation of pupillary block glaucoma. Note the dense fibrinous material/membrane covering almost the entire pupil. 

Pupillary block glaucoma may commonly occur secondary to:

  • Aphakia or pseudophakia with either anterior vitreous displacement, dislocated anterior or posterior intraocular lens, or pupillary capture by intraocular lens implant
  • Ectopia lentis
  • Phacomorphic glaucoma due to cataractous lens intumesence

Management

  • Anti-glaucoma therapy (i.e. aqueous suppressant therapy) initially
  • Miotic drops may be helpful to eliminate the pupillary block / iris bombe
  • Surgical therapy often needed (procedures may include laser iridotomy, laser iridoplasty, surgical iridectomy, or glaucoma filtering surgery)