Phacomorphic Glaucoma: Causes, Symptoms, and Treatments
Phacomorphic glaucoma is a severe eye disease that originates from a mature or swollen cataract and becomes a secondary angle-closure glaucoma. It demands emergency treatment since late treatment may cause permanent damage to the optic nerve and result in permanent blindness. The majority of cases are found in individuals with untreated or chronic cataracts, primarily in regions where regular visits to an eye doctor are challenging.
Phacomorphic glaucoma highlights the importance of early cataract detection and treatment. The condition is frequently seen in older adults and may be more prevalent in developing regions. Understanding the causes, symptoms, and available treatments is vital for both patients and caregivers to ensure timely medical intervention.
What is Phacomorphic Glaucoma?
Phacomorphic glaucoma is a form of secondary angle-closure glaucoma caused by a swollen, mature cataract that pushes the iris forward. This leads to blockage of the aqueous humour drainage through the trabecular meshwork, resulting in a rapid increase in intraocular pressure (IOP).
The increased pressure can severely damage the optic nerve if not treated promptly. This condition is classified under lens-induced glaucomas and typically occurs in eyes with advanced cataracts.
Symptoms of Phacomorphic Glaucoma
Elevated Intraocular Pressure (IOP)
A sudden increase in IOP is the most critical symptom. It causes severe discomfort and poses a high risk of permanent optic nerve damage if not controlled quickly.
Blurry Vision or Vision Loss
As the cataract progresses and IOP rises, patients may notice a sudden decrease in vision or a general cloudiness, which can worsen over hours or days.
Severe Eye Pain
Intense, throbbing pain in the affected eye is a hallmark symptom. It may radiate to the surrounding areas of the head and face.
Redness and Swelling of the Eye
The eye may appear visibly red due to increased pressure and inflammation. Swelling of the cornea can also occur, contributing to blurred vision.
Nausea and Vomiting
Systemic symptoms like nausea and vomiting often accompany acute IOP spikes, mimicking a migraine or gastrointestinal upset.
Diagnosis of Phacomorphic Glaucoma
Visual Acuity Test
A basic eye test to measure the clarity of vision, which is usually reduced in patients with phacomorphic glaucoma.
Tonometry (IOP Measurement)
This test is essential for detecting elevated intraocular pressure and confirming the presence and severity of glaucoma.
Slit-Lamp Examination
Helps in identifying a swollen or mature lens and signs of angle closure. It also allows the ophthalmologist to assess corneal clarity and anterior chamber depth.
Gonioscopy for Angle Evaluation
A crucial test to evaluate the drainage angle between the cornea and the iris. In phacomorphic glaucoma, the angle is typically narrow or closed due to the swollen lens.
Treatment for Phacomorphic Glaucoma
Cataract Surgery for Phacomorphic Glaucoma
The most definitive treatment is cataract extraction. Once the swollen lens is removed, the intraocular pressure often returns to normal. This surgery is typically performed urgently to preserve vision.
Medications to Lower IOP
Initial treatment includes medications to rapidly lower IOP. These may include topical beta-blockers, carbonic anhydrase inhibitors, and alpha agonists.
Topical or Oral Hyperosmotic Agents
Drugs like mannitol or glycerin are used to quickly reduce fluid volume in the eye and bring down IOP before surgery can be performed.
Laser Treatment for IOP Reduction
In cases where surgery cannot be performed immediately, laser iridotomy or cyclophotocoagulation may be used as temporary measures to manage pressure.
Management of Phacomorphic Glaucoma
Post-Surgery Care
After cataract surgery, patients are advised to follow a strict regimen of antibiotic and anti-inflammatory drops. Regular follow-up ensures that pressure remains stable and no complications arise.
Long-term Monitoring of IOP
Even after surgery, periodic IOP checks are necessary to rule out chronic glaucoma. Some patients may develop residual angle damage that requires ongoing treatment.
Lifestyle Modifications to Support Eye Health
Maintaining a healthy diet rich in antioxidants, managing underlying health conditions like diabetes, and avoiding smoking can support overall eye health and prevent complications.
When to See a Doctor for Phacomorphic Glaucoma
Immediate medical attention is required if you experience sudden vision loss, severe eye pain, or other signs of elevated eye pressure. Delayed treatment can lead to irreversible damage to the optic nerve and permanent blindness. Routine cataract evaluations can help prevent progression to phacomorphic glaucoma.
Frequently Asked Questions (FAQs) about Phacomorphic Glaucoma
What is the difference between phacomorphic and phacolytic glaucoma?
Phacomorphic glaucoma results from a swollen cataract lens causing angle-closure and raised intraocular pressure. Phacolytic glaucoma, on the other hand, occurs due to leakage of lens proteins from a hypermature cataract, causing inflammation and open-angle glaucoma. Both are secondary glaucomas, but their mechanisms and treatment approaches differ.
Can phacomorphic glaucoma lead to permanent vision loss?
Yes, phacomorphic glaucoma can lead to permanent vision loss if not treated promptly. The sudden increase in intraocular pressure can damage the optic nerve. Early diagnosis and cataract removal are essential to prevent irreversible vision impairment or blindness caused by prolonged elevated eye pressure.
Is cataract surgery safe for patients with phacomorphic glaucoma?
Cataract surgery is generally considered the most effective treatment for phacomorphic glaucoma. When performed by an experienced ophthalmologist, it is safe and significantly reduces intraocular pressure. However, the surgery must be carefully planned, and patients require close postoperative monitoring to manage pressure fluctuations and inflammation.
Who is at risk for developing phacomorphic glaucoma?
Individuals with untreated, mature, or hypermature cataracts, particularly older adults, are at higher risk for phacomorphic glaucoma. The condition is more common in populations with limited access to routine eye care, where cataracts may progress unchecked, increasing the risk of lens-induced angle-closure glaucoma.
What are the potential complications of phacomorphic glaucoma?
If not managed promptly, phacomorphic glaucoma can cause irreversible optic nerve damage, leading to permanent vision loss. Other complications may include chronic glaucoma, corneal oedema, inflammation, or intraocular pressure spikes even after surgery. Early diagnosis and timely cataract removal are crucial to avoid these outcomes.
Which cataract is associated with phacomorphic glaucoma?
Phacomorphic glaucoma is associated with a mature or intumescent cataract. As the cataract swells, it physically narrows the anterior chamber angle, blocking aqueous humour drainage and causing a rapid rise in intraocular pressure. This mechanical obstruction forms the basis of this secondary angle-closure glaucoma.
This information is for general awareness only and cannot be construed as medical advice. Recovery Timelines, specialist availability, and treatment prices may vary. Please consult our specialists or visit your nearest branch for more details.Insurance coverage and associated costs may vary depending on the treatment and the specific inclusions under your policy. Please visit the insurance desk at your nearest branch for detailed information.
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