Phacolytic Glaucoma

Phacolytic glaucoma in a patient with mature cataract. 

  • 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)