Phacomorphic glaucoma

Schematic diagram of the human eye

Phacomorphic glaucoma is a form of secondary glaucoma that occurs due to the morphological changes in the lens of the eye, which lead to an increase in intraocular pressure (IOP). This condition is typically associated with mature or hypermature cataracts, where the lens becomes swollen, causing a narrowing of the anterior chamber angle, which in turn impedes the normal outflow of aqueous humor and results in increased IOP.

Causes

Phacomorphic glaucoma is primarily caused by the physical enlargement of the crystalline lens, which can be due to the natural aging process leading to a mature or hypermature cataract. Other contributing factors may include diabetes, trauma, or any condition that leads to rapid swelling of the lens.

Symptoms

Patients with phacomorphic glaucoma may experience a sudden onset of symptoms, including:

• Severe eye pain
• Blurred vision
• Halos around lights
• Redness of the eye
• Headache
• Nausea and vomiting

These symptoms are due to the rapid rise in intraocular pressure, which if not promptly treated, can lead to permanent vision loss.

Diagnosis

Diagnosis of phacomorphic glaucoma involves a comprehensive eye examination, including:

• Measurement of intraocular pressure using tonometry
• Anterior chamber angle assessment through gonioscopy
• Examination of the lens and anterior chamber depth with slit lamp biomicroscopy
• Visual acuity test

Treatment

The treatment of phacomorphic glaucoma aims at reducing the intraocular pressure and addressing the underlying lens pathology. Treatment options include:

• Medical therapy to lower IOP, such as topical beta-blockers, alpha agonists, and carbonic anhydrase inhibitors
• Laser therapy, like peripheral iridotomy, to facilitate aqueous humor outflow
• Surgical intervention, primarily through phacoemulsification with intraocular lens implantation, to remove the cataract and resolve the mechanical blockage of aqueous humor outflow

Prevention

Preventive measures for phacomorphic glaucoma include regular eye examinations, especially for individuals over the age of 60 or those with risk factors for cataracts. Early detection and management of cataracts can prevent the development of phacomorphic glaucoma.

See also

• Glaucoma
• Cataract
• Intraocular pressure
• Secondary glaucoma