Glaucoma, Phacomorphic

Author: Harpreet Gill, MD; Chief Editor: Hampton Roy Sr, MD more...

Updated: Apr 20, 2010

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Background
Pathophysiology
Epidemiology
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Background

Phacomorphic glaucoma is the term used for 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.

Phacomorphic glaucoma is shown in the image below.

Phacomorphic glaucoma.

Pathophysiology

In an eye with advanced cataract formation, the lens is swollen or intumescent. Progressive reduction occurs in the iridocorneal angle. In such eyes, pupillary block glaucoma is caused by changes in the size of the lens and the position of the anterior lens surface. Angle closure may be secondary to an enhanced pupillary block mechanism, or it may be due to forward displacement of the lens-iris diaphragm.

Frequency

International

Although no formal epidemiologic statistics are available, angle closure from hypermature cataracts is more common in countries where cataracts are common and surgery is not readily available.

Race

Phacomorphic glaucoma can occur in any race.

Sex

Phacomorphic glaucoma occurs equally in men and women.

Age

Generally, phacomorphic glaucoma is observed in older patients with senile cataracts, but it can occur in younger patients after a traumatic cataract or a rapidly developing intumescent cataract.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Harpreet Gill, MD Staff Physician, Henry Ford Ophthalmology

Harpreet Gill, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Mark S Juzych, MD, MHSA Chief, Department of Ophthalmology, Harper Hospital; Associate Chair and Program Director, Associate Professor, Department of Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine

Mark S Juzych, MD, MHSA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Association, Association for Research in Vision and Ophthalmology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Anju Gupta Goyal, MD Assistant Professor of Ophthalmology, Kresge Eye Institute, Wayne State University; Director of Resident's Clinic, Kresge Eye Institute

Anju Gupta Goyal, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, and Michigan State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard W Allinson, MD Associate Professor, Department of Ophthalmology, Texas A&M University Health Science Center; Senior Staff Ophthalmologist, Scott and White Clinic

Richard W Allinson, MD, is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Martin B Wax, MD Clinical Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Ophthalmology Research and Development, Head, Ophthalmology Discovery Research, Alcon Labs, Inc

Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Society for Neuroscience

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

Tham CC, Lai JS, Poon AS, Chan JC, Lam SW, Chua JK, et al. Immediate argon laser peripheral iridoplasty (ALPI) as initial treatment for acute phacomorphic angle-closure (phacomorphic glaucoma) before cataract extraction: a preliminary study. Eye (Lond). Jul 2005;19(7):778-83. [Medline].
Leung CK, Chan WM, Ko CY, Chui SI, Woo J, Tsang MK, et al. Visualization of anterior chamber angle dynamics using optical coherence tomography. Ophthalmology. Jun 2005;112(6):980-4. [Medline].
Dada T, Kumar S, Gadia R, Aggarwal A, Gupta V, Sihota R. Sutureless single-port transconjunctival pars plana limited vitrectomy combined with phacoemulsification for management of phacomorphic glaucoma. J Cataract Refract Surg. Jun 2007;33(6):951-4. [Medline].
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