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    Lens Related Glaucoma

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    Usama Butt
    This document discusses different types of lens-related glaucoma, including phacomorphic, phacolytic, and phacoantigenic glaucoma. Phacomorphic glaucoma is caused by pupil block from a swollen cataractous lens. Phacolytic glaucoma results from proteins leaking from a mature or hypermature cataract that clog the trabecular meshwork. Phacoantigenic glaucoma occurs when lens proteins cause an inflammatory reaction after the lens capsule is ruptured. The document provides details on the pathophysiology, symptoms, signs, and treatment options for each type of lens-related glaucoma.

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    © All Rights Reserved
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    Lens Related Glaucoma

    Uploaded by

    Usama Butt
    263 views19 pages
    This document discusses different types of lens-related glaucoma, including phacomorphic, phacolytic, and phacoantigenic glaucoma. Phacomorphic glaucoma is caused by pupil block from a swollen cataractous lens. Phacolytic glaucoma results from proteins leaking from a mature or hypermature cataract that clog the trabecular meshwork. Phacoantigenic glaucoma occurs when lens proteins cause an inflammatory reaction after the lens capsule is ruptured. The document provides details on the pathophysiology, symptoms, signs, and treatment options for each type of lens-related glaucoma.

    Original Description:

    Phacogenic Glaucoma

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    This document discusses different types of lens-related glaucoma, including phacomorphic, phacolytic, and phacoantigenic glaucoma. Phacomorphic glaucoma is caused by pupil block from a swollen cataractous lens. Phacolytic glaucoma results from proteins leaking from a mature or hypermature cataract that clog the trabecular meshwork. Phacoantigenic glaucoma occurs when lens proteins cause an inflammatory reaction after the lens capsule is ruptured. The document provides details on the pathophysiology, symptoms, signs, and treatment options for each type of lens-related glaucoma.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    263 views19 pages

    Lens Related Glaucoma

    Uploaded by

    Usama Butt
    This document discusses different types of lens-related glaucoma, including phacomorphic, phacolytic, and phacoantigenic glaucoma. Phacomorphic glaucoma is caused by pupil block from a swollen cataractous lens. Phacolytic glaucoma results from proteins leaking from a mature or hypermature cataract that clog the trabecular meshwork. Phacoantigenic glaucoma occurs when lens proteins cause an inflammatory reaction after the lens capsule is ruptured. The document provides details on the pathophysiology, symptoms, signs, and treatment options for each type of lens-related glaucoma.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 19

    Lens related Glaucoma

    ZAIN UL ABIDEEN
    ROLL NO. 41

    Learning Objectives
    Definition
    Types
    Pathophysiology
    Diagnosis
    Treatment

    Definition
    Glaucoma that develops secondary to any pathology

    of crystalline Lens.
    Can be:

    Secondary Open-Angle Glaucoma


    2. Secondary Angle-Closure Glaucoma
    1.

    Types
    Phacomorphic Glaucoma
    Phacolytic Glaucoma
    Phacoantigenic Glaucoma

    Phaco-Morphic Glaucoma
    Its a secondary angle-closure glaucoma due to

    lens intumescence.
    The increase in lens thickness from an advanced
    cataract, a rapidly intumescent lens, or a traumatic
    cataract can lead to pupillary block and angle
    closure.

    Patho-Physiology :

    The Swollen Cataractous Lens during, its


    Immature/Mature stage may push against the back
    of Iris and cause relative pupilary block.
    This causes accumulation of aqueous in posterior
    chamber, which pushes the flexible Iris in forward
    direction that causes closure of Anterior Chamber
    Angle. This Results in Rise of IOP.

    Sypmtoms:

    Acute pain, Blurred vision, Rainbow-colored halos


    around lights, Nausea, and Vomiting.
    Signs:
    High intraocular pressure (IOP) - Greater than 35
    mm Hg
    Middilated, sluggish, irregular pupil
    Corneal edema
    Injection of conjunctival and episcleral vessels
    Shallow central anterior chamber (AC)
    Lens enlargement and forward displacement
    Unequal cataract formation between the 2 eyes

    Treatment:

    Beta-blockers, alpha 2-adrenergic agonists,


    prostaglandin analogs and carbonic anhydrase
    inhibitors.
    2. Laser iridotomy to relieve the pupillary block.
    3. Lens Extraction is the ultimate treatment option.
    1.

    Phaco-Lytic Glaucoma
    Phacolytic glaucoma (PG) is the sudden onset of

    open-angle glaucoma caused by a leaking mature


    or hypermature (rarely immature) cataract.
    Pathophysioloy:

    In hypermature cataract Lens protein leak through the


    intact capsule into the aqueous. The macrophages
    phagocytose these Lens Proteins. The Trabecular
    meshwork is blocked by both the lens proteins and
    macrophages.

    Sypmtoms:
    History of slow vision loss for months or years prior to
    the acute onset of pain, redness, and sometimes
    further decrease in vision.
    Signs:
    Raised IOP
    Corneal edema
    The anterior chamber contains Intense flare, Large

    cells (macrophages) and Aggregates of white material,

    Treatment:

    Initial treatment of phacolytic glaucoma is focused upon

    acute lowering of IOP using a combination of topical and


    systemic IOP-lowering agents.
    Topical steroids also may facilitate IOP lowering and
    decrease pain.
    The definitive treatment of phacolytic glaucoma (PG) is
    cataract extraction:
    Extracapsular cataract extraction (eg.
    phacoemulsification) is prefferd treatment.
    PG is caused by a lens that has dislocated into the vitreous
    cavity, the procedure of choice is pars plana vitrectomy.

    Phaco-antigenic Glaucoma
    Phacoanaphylaxis/lens-induced uveitis occurs in the setting

    of a ruptured or degenerative lens capsule and is


    characterized by a granulomatous antigenic reaction to lens
    protein.
    Pathophysiology:
    Trauma causes tear in the Lens capsule that results into the
    Imbibition of water and Cataract formation. At the same time
    lens proteins are also released which acts as Antigen and
    produce antibodies.
    The antigen-antibody reaction occurs on the surface of Iris,
    Cilliary body and Lens, this lens induced uveitis may cause
    Secodnary Glaucoma = Inflammatory Glaucoma

    Symptoms:

    Severe light sensitivity


    Epiphora
    Pain,
    Floaters,
    Decreased vision
    Redness of the eye
    Signs:
    Important clinical signs of lens-induced Uveitis are Corneal
    haze, Keratic, Cells and Flare, Fibrin in AC , Peripheral
    Anterior Synechiae, Posterior Synechiae.

    Treatment:
    Corticosteroids
    NSAIDS
    IOP lowering Drugs : B-Blockers, Carbonic
    Anhydrase Inhibitors, Alpha-Agonists.
    If Medical treatment fails, Surgical Removal of Lens
    Material is Planed.

    THANK YOU

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