Original Research Article
Year: 2020 | Month: December | Volume: 7 | Issue: 12 | Pages: 404-411
Lens Induced Glaucoma- An Entity Revisited
Mukta Prasad
Senior Resident, Department of Ophthalmology, Patna Medical College, Patna. Bihar- 800 004
ABSTRACT
Lens induced glaucomas are high occurrence in India, hardly surprising in a situation where the incidence of cataract cases far exceeds the total number of surgeries performed. Lens induced glaucoma may be due to many different reasons but ultimately they compromise the function of the optic nerve due to rise of intraocular pressure.
Method- A prospective study consisting forty two (42) cases of lens induced glaucoma over a period of two years upto July, 2020. Detailed history was recorded and patients have been evaluated for cause of lens induced mechanisms which led to symptoms. Proforma was prepared for this study and all findings were noted. Medical management was essential for controlling acute increase of intraocular pressure (IOP). Then planned surgery by lens extraction with or without posterior chamber Intraocular lens (PCIOL) was done. Some cases were managed by buttonhole iridectomy after getting diagnosed of posterior capsular rupture. Small Incision Cataract Surgery(SICS) was preferred for lens extraction. Only 2 cases had vision less than 6/60.
Results - 59.6% of cases were Phacolytic glaucoma with another 23.8% of Phacomorphic glaucoma cases. Lens dislocation numbered in less cases and one case of lens particle glaucoma was also managed in this series. Elderly females in 55-60 years age range were mostly affected in Phacomorphic and Phacolytic glaucoma. Young male presented mostly with traumatic dislocations. Acute elevated Intraocular pressure (IOP) with pain and redness was noted as presenting feature.
Conclusion- Prevalence of lens induced glaucoma is to be considered when symptomatic cataract is met in practice. High load of cataract cases often make surgeon to ignore mild symptoms which may lead to blindness. Cataract extraction is curative in Phacomorphic and Phacolytic glaucoma. Symptomatic relief by medical management should not be the only venture. Swift surgical correction is important with strict follow-up.
Keywords: Blindness, Phacomorphic, Phacolytic, Lens Particle, Lens Dislocation, Trauma.
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