Phacomorphic glaucoma is an eye condition that can lead to significant vision impairment and, if left unaddressed, permanent vision loss. It is a form of glaucoma where elevated eye pressure is directly linked to changes within the eye’s natural lens. Understanding this condition is important for recognizing its potential impact on ocular health.
What is Phacomorphic Glaucoma?
Phacomorphic glaucoma is classified as a type of secondary angle-closure glaucoma. This means elevated pressure within the eye is a consequence of an underlying ocular issue, specifically abnormalities of the crystalline lens. An “intumescent lens” refers to a lens that has significantly swollen or increased in volume. This swelling most commonly occurs due to the progression of a cataract, where the lens fibers absorb water and expand.
How Phacomorphic Glaucoma Develops
The development of phacomorphic glaucoma begins when the natural lens inside the eye becomes significantly swollen, typically due to an advanced or hypermature cataract. As the lens increases in size, it pushes the iris forward. This forward movement of the iris can narrow or completely block the anterior chamber angle, which is the drainage pathway for the aqueous humor.
The aqueous humor is a clear fluid continuously produced within the eye that nourishes the eye’s structures and maintains its shape. When the drainage angle is blocked, the aqueous humor cannot exit the eye properly, leading to a rapid buildup of intraocular pressure (IOP). This sudden increase in IOP can then cause damage to the optic nerve.
Symptoms and Diagnosis
Individuals experiencing phacomorphic glaucoma often report a sudden onset of symptoms due to the rapid rise in intraocular pressure. Common indicators include severe eye pain, eye redness, blurred or hazy vision, and the perception of halos around lights. Headaches, particularly on the affected side, may also accompany these symptoms.
An ophthalmologist diagnoses phacomorphic glaucoma through a comprehensive eye examination. This involves measuring the intraocular pressure using a tonometer, a device that assesses the fluid pressure inside the eye. Further diagnostic steps include gonioscopy, which allows the doctor to visualize and assess the drainage angle, and an examination of the lens to confirm swelling and the optic nerve for damage.
Treatment Options and Prognosis
The immediate treatment for phacomorphic glaucoma focuses on reducing high intraocular pressure to prevent further optic nerve damage. This is often achieved using medications, such as topical eye drops and oral medications, to quickly lower fluid production within the eye.
The definitive treatment involves the surgical removal of the swollen cataractous lens, a procedure known as cataract extraction. This surgery removes the obstruction, allowing the aqueous humor to drain normally and permanently relieving the angle blockage. Timely surgical intervention is important to minimize the risk of irreversible vision loss. Following successful lens removal and pressure normalization, the prognosis for vision preservation is favorable, though some pre-existing optic nerve damage may persist.