lens induced glaucoma

Lens induced glaucoma

Lens-induced glaucoma may occur as either secondary angle-closure or open-angle glaucoma. The angle-closure can be caused by lens swelling (phacomorphic glaucoma) or lens dislocation (ectopia lentis). The open-angle glaucomas include glaucoma related to: leakage of lens proteins through the capsule of a mature or hypermature cataract (phacolytic glaucoma), obstruction of the trabecular meshwork following cataract extraction, capsulotomy, or ocular trauma by liberated fragments of lens material (lens-particle glaucoma), and hypersensitivity to own lens protein following surgery or penetrating trauma (phacoantigenic glaucoma). (ref)

Types of Lens induced glaucoma

Lens induced secondary angle-closure glaucoma

1.Phacomorphic Glaucoma

2.Glaucoma induced by Lens-dislocation

Lens induced open-angle glaucoma

1.Phacolytic Glaucoma

2.Lens-Particle Glaucoma

3. Phacoantigenic Glaucoma (formerly known as Phacoanaphylaxis)

What causes lens-induced glaucoma?


Intumescent (swollen) cataract pushes the iris narrowing the angle or  apposes the pupil margin  causing pupillary block.


A mature cataract leaks  denatured lens proteins.  Macrophages phagocytose  these proteins and clog the Trabecular Meshwork.


Normal lens proteins leak into  the AC after trauma or capsule  disruption. A granulomatous reaction to these normal

proteins ensues.

what is Lens Particle

Pieces of lens particles (e.g.,  after cataract surgery)  physically obstruct the angle.

What is a pupillary block?

Pupillary Block = The anterior lens comes into contact with the pupillary margin and prevents the normal flow of aqueous

image 39
Lens induced glaucoma illustration

Lens-Induced Glaucoma:
▪️Phacomorphic Glaucoma:
It denotes glaucoma due to alteration in morphology of lens.

Lens induced glaucoma, Intumescent lens.

Phacomorphic Glaucoma is diagnosed by the presence of eye pain, history of decreased vision, evidence of mature cataract formation (slit lamp exam), angle closure (gonioscopy), and elevated intraocular pressure (applanation tonometry) in the affected eye. 

1. Intumescent lens.
2. Microspherophakia is generally associated with anterior subluxation or dislocation of lens.

Lens induced glaucoma

▪️Phacolytic Glaucoma:
It occurs due to leakage of proteins from the wrinkled capsule of hypermature morgagnian cataract which block the trabecular meshwork leading to glaucoma.

Lens induced glaucoma,Phacolytic Glaucoma:

▪️Lens Particle Glaucoma or Phacotoxic Glaucoma:
It occurs due to rupture of lens capsule (due to trauma), leading to release of lot of lens particles causing clogging of trabecular meshwork hence causing glaucoma.

Lens induced glaucoma,Glaucoma Associated with Phacoanaphylaxis

▪️Glaucoma Associated with Phacogenic Uveitis:
It denotes to the uveitis occurring due to leaked lens proteins and contributing to the development of glaucoma.
▪️Glaucoma Associated with Phacoanaphylaxis:
It denotes to the anaphylactic reaction, causing accumulation of macrophages, which engulf the lens protein and block the trabecular meshwork leading to glaucoma.

Lens induced glaucoma

Phacoantigenic glaucoma is a granulomatous inflammatory reaction directed against own lens antigens after surgery or penetrating trauma, leading to obstruction of the trabecular meshwork and increased intraocular pressure.

Credit: Image-Based Review of Ophthalmology.
Photo credit of illustration: EyeFlyMD.

Leave a Reply

Your email address will not be published. Required fields are marked *