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Open -Angle
Phacolytic glaucoma in a patient with mature cataract.

  • A form of lens-induced open-angle glaucoma.
  • Caused by the leakage of lens protein (from a mature or hypermature cataract) into the aqueous humor, thereby causing obstruction of aqueous outflow.
  • Clinical features:
    • Symptoms: may present as sudden or insidious onset of ocular pain and worsened vision
    • Signs:
      • Occurs unilaterally (majority of cases)
      • Conjunctival hyperemia (associated)
      • Acutely elevated intraocular pressure (may reach as high as 80 mmHg)
      • Diffuse corneal edema
      • Inflammatory cells in the anterior chamber
      • Presence of white patches on the anterior lens capsule probably representing phagocytosis of lens protein by macrophages
      • On gonioscopy evaluation, the anterior chamber angle appears open
  • Management:
    • Anti-inflammatory therapy
    • Anti-glaucoma medication(s)
    • Cataract removal surgery (the IOP usually returns to normal in several days)

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