Phacomorphic glaucoma: Difference between revisions
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{{Infobox medical condition | |||
| name = Phacomorphic glaucoma | |||
| image = [[File:Schematic_diagram_of_the_human_eye.png|250px]] | |||
| caption = Schematic diagram of the human eye | |||
| field = [[Ophthalmology]] | |||
| symptoms = [[Eye pain]], [[blurred vision]], [[headache]], [[nausea]] | |||
| complications = [[Vision loss]], [[optic nerve damage]] | |||
| onset = Sudden | |||
| duration = Variable | |||
| causes = [[Lens swelling]] due to [[cataract]] | |||
| risks = Advanced [[age]], [[hyperopia]], [[family history]] | |||
| diagnosis = [[Ophthalmic examination]], [[slit lamp examination]], [[intraocular pressure]] measurement | |||
| differential = [[Acute angle-closure glaucoma]], [[uveitis]], [[conjunctivitis]] | |||
| treatment = [[Surgical intervention]], [[medications]] to lower [[intraocular pressure]] | |||
| medication = [[Topical beta-blockers]], [[carbonic anhydrase inhibitors]], [[osmotic agents]] | |||
| prognosis = Good with timely treatment | |||
| frequency = Rare | |||
}} | |||
{{Short description|A type of secondary angle-closure glaucoma}} | {{Short description|A type of secondary angle-closure glaucoma}} | ||
'''Phacomorphic glaucoma''' is a form of [[secondary glaucoma]] that occurs due to the swelling of the [[crystalline lens]] in the eye, leading to [[angle closure]] and increased [[intraocular pressure]] (IOP). This condition is often associated with [[cataract]] formation, where the lens becomes increasingly opaque and enlarged, causing mechanical obstruction of the [[anterior chamber angle]]. | '''Phacomorphic glaucoma''' is a form of [[secondary glaucoma]] that occurs due to the swelling of the [[crystalline lens]] in the eye, leading to [[angle closure]] and increased [[intraocular pressure]] (IOP). This condition is often associated with [[cataract]] formation, where the lens becomes increasingly opaque and enlarged, causing mechanical obstruction of the [[anterior chamber angle]]. | ||
==Pathophysiology== | ==Pathophysiology== | ||
Phacomorphic glaucoma arises when the lens of the eye becomes swollen due to advanced cataract formation. The swollen lens pushes the [[iris]] forward, narrowing or closing the anterior chamber angle, which is the drainage pathway for the [[aqueous humor]]. This obstruction prevents the normal outflow of aqueous humor, leading to an increase in intraocular pressure. The elevated IOP can cause damage to the [[optic nerve]], resulting in vision loss if not treated promptly. | Phacomorphic glaucoma arises when the lens of the eye becomes swollen due to advanced cataract formation. The swollen lens pushes the [[iris]] forward, narrowing or closing the anterior chamber angle, which is the drainage pathway for the [[aqueous humor]]. This obstruction prevents the normal outflow of aqueous humor, leading to an increase in intraocular pressure. The elevated IOP can cause damage to the [[optic nerve]], resulting in vision loss if not treated promptly. | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
Patients with phacomorphic glaucoma typically present with symptoms of acute angle-closure glaucoma, including: | Patients with phacomorphic glaucoma typically present with symptoms of acute angle-closure glaucoma, including: | ||
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* [[Halos around lights]] | * [[Halos around lights]] | ||
* [[Red eye]] | * [[Red eye]] | ||
On examination, the affected eye may show a shallow anterior chamber, a mid-dilated and non-reactive pupil, and corneal edema. The intraocular pressure is usually significantly elevated. | On examination, the affected eye may show a shallow anterior chamber, a mid-dilated and non-reactive pupil, and corneal edema. The intraocular pressure is usually significantly elevated. | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of phacomorphic glaucoma is primarily clinical, based on the history and examination findings. [[Gonioscopy]] can be used to assess the angle closure, and [[ultrasound biomicroscopy]] may help in evaluating the lens size and position. [[Optical coherence tomography]] (OCT) can also be useful in assessing the anterior segment structures. | The diagnosis of phacomorphic glaucoma is primarily clinical, based on the history and examination findings. [[Gonioscopy]] can be used to assess the angle closure, and [[ultrasound biomicroscopy]] may help in evaluating the lens size and position. [[Optical coherence tomography]] (OCT) can also be useful in assessing the anterior segment structures. | ||
==Management== | ==Management== | ||
The management of phacomorphic glaucoma involves both medical and surgical interventions: | The management of phacomorphic glaucoma involves both medical and surgical interventions: | ||
===Medical Management=== | ===Medical Management=== | ||
Initial treatment focuses on lowering the intraocular pressure and relieving symptoms. This may include: | Initial treatment focuses on lowering the intraocular pressure and relieving symptoms. This may include: | ||
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* [[Carbonic anhydrase inhibitors]] (e.g., [[acetazolamide]]) | * [[Carbonic anhydrase inhibitors]] (e.g., [[acetazolamide]]) | ||
* [[Hyperosmotic agents]] (e.g., [[mannitol]]) | * [[Hyperosmotic agents]] (e.g., [[mannitol]]) | ||
===Surgical Management=== | ===Surgical Management=== | ||
Definitive treatment requires surgical intervention to remove the cataractous lens. The most common procedure is [[phacoemulsification]], which involves emulsifying and aspirating the lens material, followed by the implantation of an [[intraocular lens]]. In some cases, a [[trabeculectomy]] or other glaucoma surgery may be necessary to manage the intraocular pressure. | Definitive treatment requires surgical intervention to remove the cataractous lens. The most common procedure is [[phacoemulsification]], which involves emulsifying and aspirating the lens material, followed by the implantation of an [[intraocular lens]]. In some cases, a [[trabeculectomy]] or other glaucoma surgery may be necessary to manage the intraocular pressure. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis for phacomorphic glaucoma depends on the duration and severity of the angle closure and the extent of optic nerve damage. Early diagnosis and prompt surgical intervention can lead to a good visual outcome. However, delayed treatment may result in permanent vision loss due to optic nerve damage. | The prognosis for phacomorphic glaucoma depends on the duration and severity of the angle closure and the extent of optic nerve damage. Early diagnosis and prompt surgical intervention can lead to a good visual outcome. However, delayed treatment may result in permanent vision loss due to optic nerve damage. | ||
==Prevention== | ==Prevention== | ||
Preventive measures include regular eye examinations, especially in older adults at risk for cataract formation. Early detection and management of cataracts can prevent the development of phacomorphic glaucoma. | Preventive measures include regular eye examinations, especially in older adults at risk for cataract formation. Early detection and management of cataracts can prevent the development of phacomorphic glaucoma. | ||
==See also== | |||
== | |||
* [[Glaucoma]] | * [[Glaucoma]] | ||
* [[Cataract]] | * [[Cataract]] | ||
* [[Angle-closure glaucoma]] | * [[Angle-closure glaucoma]] | ||
* [[Intraocular pressure]] | * [[Intraocular pressure]] | ||
[[Category:Glaucoma]] | [[Category:Glaucoma]] | ||
[[Category:Ophthalmology]] | [[Category:Ophthalmology]] | ||
Latest revision as of 15:31, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Phacomorphic glaucoma | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Eye pain, blurred vision, headache, nausea |
| Complications | Vision loss, optic nerve damage |
| Onset | Sudden |
| Duration | Variable |
| Types | N/A |
| Causes | Lens swelling due to cataract |
| Risks | Advanced age, hyperopia, family history |
| Diagnosis | Ophthalmic examination, slit lamp examination, intraocular pressure measurement |
| Differential diagnosis | Acute angle-closure glaucoma, uveitis, conjunctivitis |
| Prevention | N/A |
| Treatment | Surgical intervention, medications to lower intraocular pressure |
| Medication | Topical beta-blockers, carbonic anhydrase inhibitors, osmotic agents |
| Prognosis | Good with timely treatment |
| Frequency | Rare |
| Deaths | N/A |
A type of secondary angle-closure glaucoma
Phacomorphic glaucoma is a form of secondary glaucoma that occurs due to the swelling of the crystalline lens in the eye, leading to angle closure and increased intraocular pressure (IOP). This condition is often associated with cataract formation, where the lens becomes increasingly opaque and enlarged, causing mechanical obstruction of the anterior chamber angle.
Pathophysiology[edit]
Phacomorphic glaucoma arises when the lens of the eye becomes swollen due to advanced cataract formation. The swollen lens pushes the iris forward, narrowing or closing the anterior chamber angle, which is the drainage pathway for the aqueous humor. This obstruction prevents the normal outflow of aqueous humor, leading to an increase in intraocular pressure. The elevated IOP can cause damage to the optic nerve, resulting in vision loss if not treated promptly.
Clinical Presentation[edit]
Patients with phacomorphic glaucoma typically present with symptoms of acute angle-closure glaucoma, including:
On examination, the affected eye may show a shallow anterior chamber, a mid-dilated and non-reactive pupil, and corneal edema. The intraocular pressure is usually significantly elevated.
Diagnosis[edit]
The diagnosis of phacomorphic glaucoma is primarily clinical, based on the history and examination findings. Gonioscopy can be used to assess the angle closure, and ultrasound biomicroscopy may help in evaluating the lens size and position. Optical coherence tomography (OCT) can also be useful in assessing the anterior segment structures.
Management[edit]
The management of phacomorphic glaucoma involves both medical and surgical interventions:
Medical Management[edit]
Initial treatment focuses on lowering the intraocular pressure and relieving symptoms. This may include:
- Topical beta-blockers (e.g., timolol)
- Alpha agonists (e.g., apraclonidine)
- Carbonic anhydrase inhibitors (e.g., acetazolamide)
- Hyperosmotic agents (e.g., mannitol)
Surgical Management[edit]
Definitive treatment requires surgical intervention to remove the cataractous lens. The most common procedure is phacoemulsification, which involves emulsifying and aspirating the lens material, followed by the implantation of an intraocular lens. In some cases, a trabeculectomy or other glaucoma surgery may be necessary to manage the intraocular pressure.
Prognosis[edit]
The prognosis for phacomorphic glaucoma depends on the duration and severity of the angle closure and the extent of optic nerve damage. Early diagnosis and prompt surgical intervention can lead to a good visual outcome. However, delayed treatment may result in permanent vision loss due to optic nerve damage.
Prevention[edit]
Preventive measures include regular eye examinations, especially in older adults at risk for cataract formation. Early detection and management of cataracts can prevent the development of phacomorphic glaucoma.
