Phacomorphic glaucoma

Short description: Disorder of the human eye

Phacomorphic glaucoma

Anatomy of the eye
Specialty| Ophthalmology
Complications| Blindness
Diagnostic method| Eye examination
Differential diagnosis| Phacolytic glaucoma

Phacomorphic glaucoma is an eye disease that can occur due to a neglected advanced cataract. In this, the mature cataractous lens cause secondary angle closure glaucoma. The presence of an asymmetric mature cataractous lens, shallow or closed anterior chamber angle, raised intraocular pressure (IOP) and other typical signs and symptoms of angle-closure glaucoma in the eye may lead to a diagnosis of phacomorphic glaucoma. Cataract surgery after initial IOP control with medication is the only treatment.

Phacomorphic glaucoma is one of the most common causes of secondary angle closure glaucoma in developing countries like India.

## Contents

* 1 Pathophysiology
* 2 Signs and symptoms
* 3 Investigations
* 4 Treatment
* 5 Epidemiology
* 6 See also
* 7 References

## Pathophysiology

A mature and bulging lens causes pupillary block and the iris to be pushed forward. A forward iris closes the angle and obstructs aqueous humor flow. This leads to elevated intraocular pressure and optic nerve damage. Rarely direct compression of angle by intumescent lens may also cause angle closure.[1]

## Signs and symptoms

Patient may come with the complaint of significant eye pain. Eye examination will show an elevated intraocular pressure. IOP did not respond to topical antiglaucoma drugs.[2] Asymmetric mature cataractous lens, shallow or closed angle of anterior chamber, an elevated IOP and other typical signs and symptoms of angle-closure glaucoma in the eye led to the diagnosis of Phacomorphic glaucoma.[2][3]

## Investigations

Tonometry is used to measure intraocular pressure. Gonioscopy is the gold-standard for measuring angle of anterior chamber and confirming angle closure.[3]

## Treatment

Treatment of phacomorphic glaucoma may require medical therapy, laser peripheral iridotomy or incisional surgery to quickly lower the pressure as a first step.[4] Cataract surgery should be done after initial IOP control with medication or laser.[4]

## Epidemiology

Phacomorphic glaucoma is one of the most common (incidence 3.91%) causes of secondary angle closure glaucoma in developing countries like India.[5]

## See also

* Lens induced glaucomas

## References

1. ↑ Efrem, Mandelcorn; Neeru, Gupta (11 July 2016). "Lens-Related Glaucomas". https://entokey.com/lens-related-glaucomas/.
2. ↑ 2.0 2.1 Sowka, Joseph (December 2006). "Phacomorphic glaucoma: case and review". Optometry (St. Louis, Mo.) 77 (12): 586–589. doi:10.1016/j.optm.2006.08.013. PMID 17157240. https://pubmed.ncbi.nlm.nih.gov/17157240/. Retrieved 2023-02-02.
3. ↑ 3.0 3.1 "Phacomorphic Glaucoma from an Age-related Cataractous Lens in a 97-year-old Male". https://morancore.utah.edu/section-10-glaucoma/phacomorphic-glaucoma-from-an-age-related-cataractous-lens-in-a-97-year-old-male/.
4. ↑ 4.0 4.1 "Phacomorphic Glaucoma". https://crstoday.com/articles/2008-jul/crst0708_15-php.
5. ↑ Richa, Guptha; Surabhi, Agrawal; Lokesh, Chauhan (15 April 2021). "Survival analysis of phacomorphic glaucoma at a tertiary hospital in North India". Taiwan Journal of Ophthalmology 12 (1): 61–67. doi:10.4103/tjo.tjo_87_20. PMID 35399964.

* v
* t
* e

* Diseases of the human eye (H00–H59
* 360–379)

Adnexa

| Eyelid|

| Inflammation|

* Stye
* Chalazion
* Blepharitis

|

* Entropion
* Ectropion
* Lagophthalmos
* Blepharochalasis
* Ptosis
* Blepharophimosis
* Xanthelasma

Eyelash|

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Lacrimal apparatus|

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* Epiphora
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Orbit|

* Exophthalmos
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Conjunctiva|

* Conjunctivitis
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Globe

| Fibrous tunic|

| Sclera|

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|

Cornea|

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Vascular tunic|

* Iris
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|

Choroid|

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Lens|

* Cataract
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Retina|

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Other|

* Glaucoma / Ocular hypertension / Primary juvenile glaucoma
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Pathways

| Optic nerve
Optic disc|

* Optic neuritis
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* Papilledema
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Optic neuropathy|

* Ischemic
* anterior (AION)
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* Kjer's
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* Toxic and nutritional

Strabismus
Extraocular muscles
Binocular vision
Accommodation|

| Paralytic strabismus|

* Ophthalmoparesis
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* Kearns–Sayre syndrome

palsies|

* Oculomotor (III)
* Fourth-nerve (IV)
* Sixth-nerve (VI)

Other strabismus|

* Esotropia / Exotropia
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* Esophoria
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* Brown's syndrome
* Duane syndrome

Other binocular|

* Conjugate gaze palsy
* Convergence insufficiency
* Internuclear ophthalmoplegia
* One and a half syndrome

Refraction|

* Refractive error
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* Anisometropia / Aniseikonia
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Vision disorders
Blindness|

* Amblyopia
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Anopsia|

* Hemianopsia
* binasal
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subjective|

* Asthenopia
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* Scintillating scotoma

Pupil|

* Anisocoria
* Argyll Robertson pupil
* Marcus Gunn pupil
* Adie syndrome
* Miosis
* Mydriasis
* Cycloplegia
* Parinaud's syndrome

Other|

* Nystagmus
* Childhood blindness

Infections

* Trachoma
* Onchocerciasis

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