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.

Patient Education

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Clinical Presentation

Media Gallery

Phacomorphic glaucoma.

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Author

Harpreet Gill, MD Staff Physician, Henry Ford Ophthalmology

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

Disclosure: Nothing to disclose.

Coauthor(s)

Mark S Juzych, MD, MHSA Chair and Professor (Clinician-Educator), Department Ophthalmology, Wayne State University School of Medicine; Director, Kresge Eye Institute; Ophthalmology Service Chief, Karmanos Cancer Center

Mark S Juzych, MD, MHSA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Glaucoma Society, American Medical Association, American Society of Cataract and Refractive Surgery, Association for Hospital Medical Education, Association for Research in Vision and Ophthalmology, Association of University Professors of Ophthalmology, Michigan Society of Eye Physicians & Surgeons, Michigan State Medical Society, Phi Beta Kappa, Society of Heed Fellows, Ukrainian Medical Association of North America, Wayne County Medical Society

Disclosure: Nothing to disclose.

Anju Goyal, MD Assistant Professor of Ophthalmology, Director for Medical Student Clinical Education, Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine

Anju 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

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

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

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

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

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, Texas Medical Association

Disclosure: Nothing to disclose.