Lens-Induced Uveitis and Glaucoma*

Irvine,; Ar, Irvine

doi:10.1016/0002-9394(52)91315-9

Cited by 37 publications

(5 citation statements)

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“…This viewpoint has been accepted and substantiated by numerous authors (Gifford, 1900(Gifford, , 1918(Gifford, , 1927Schwenck, 1917;Knapp, 1927;Safar, 1928;Irvine and Irvine, 1952;Ballen and Hughes, 1955;Irvine, 1957;Chandler, 1958). If the diagnosis of phacolytic glaucoma were universally unequivocal, there would be no hesitation in removing the lens.…”

Section: Discussionmentioning

confidence: 86%

“…Over 50 years later Gifford's pathogenetic explanation that "the detritus of the cortex might block the outlets" of aqueous humour was substantiated by histological study of eyes which had been unsuccessfully treated medically and subsequently enucleated (Irvine and Irvine, 1952;Flocks and others, 1955;Fenton and de Buen, 1964;Smith and Zimmerman, 1965). It is now recognized that mechanical blockade of the anterior chamber angle structures is effected by proteinaceous debris and by characteristic large macrophages which have ingested hyper-mature cortical protein of the lens.…”

Section: Discussionmentioning

confidence: 99%

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Cytological diagnosis of phacolytic glaucoma utilizing millipore filtration of the aqueous.

Goldberg

1967

British Journal of Ophthalmology

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ALTHOUGH the Millipore filtration technique of cytological analysis has been largely neglected in clinical ophthalmology (Goldberg, Erozan, Duke, and Frost, 1965; Jarrett, Goldberg, and Schulze, 1966), it can be of practical assistance in diagnosis and therapy. Documentation of this usefulness is provided by the following report of morgagnian cataract with phacolytic glaucoma. Case ReportAn 88-year-old man of Ukrainian descent complained of decreasing vision of 20 years' duration.Vision had painlessly and progressively decreased in the right eye until 8 years before admission, when he had been struck in the right eye with a tree branch and sustained a laceration of the upper lid. Subsequently, there was further decrease in vision of the right eye. One week before admission, redness and mild pain were noted and topical corticosteroids were instituted by the patient's general practitioner. On the day of admission the patient's niece had discovered that the right cornea appeared to be white and opaque.Examination.-The visual acuity was perception of light with good projection in the right eye and 20/60 (with -0-5D sph.) in the left. Except for early nuclear sclerosis of the lens, the left eye was normal.On the right the conjunctiva was moderately and diffusely hyperaemic without discharge. The cornea had a cloudy white appearance, through which the pupil was barely discernible. Biomicroscopical examination showed oedema of the corneal epithelium, a normal stroma, and no keratic precipitates. The anterior chamber was of normal depth but was completely filled with milky material containing myriads of tiny, iridescent, pin-point particles. The anterior chamber angle could not be visualized with a gonioprism. No details of the iris were visible. After the instillation of glycerine drops, biomicroscopy revealed a barely visible iridescent cataract. A pinkishwhite fundus reflex was obtained.The intra-ocular pressure was 43 4 mm. Hg (Schiotz) in the right eye and 14-6 mm. Hg (Schiotz) in the left.A clinical diagnosis of severe iritis was made; other possibilities included necrotic intra-ocular neoplasm, retained intra-ocular foreign body, metastatic endophthalmitis, glaucomatocyclitic crisis of Posner-Schlossman, and lens-induced glaucoma. The patient was treated with a systemic carbonic anhydrase inhibitor and topical l-epinephrine, atrophine, and phenylephrine without relief. Systemic penicillin and chloramphenicol were started on the following day, and hourly CortisporinR eye drops were added to the therapeutic regimen. In the next 3 days there was no appreciable change.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Cytological diagnosis of phacolytic glaucoma utilizing millipore filtration of the aqueous.

Goldberg

1967

British Journal of Ophthalmology

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“… 14 , 15 In a phacolytic response degenerated lens protein is phagocytosed by macrophages, which occlude trabecular meshwork leading to secondary open angle glaucoma. 16 , 17 , 18 Retained lens fragments can cause mechanical damage to corneal endothelium and mechanical obstruction of the trabecular outflow. 19 Our three patients all demonstrate a distinct, to our knowledge previously unreported, mechanism of delayed post-operative complication of cataract extraction – the dispersion of minute, talc-like calcific particles from fragmenting or degenerating Soemmering ring cataract.…”

Section: Discussionmentioning

confidence: 99%

Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation

Safran

Nataneli²,

Vazirani³

et al. 2022

American Journal of Ophthalmology Case Reports

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“…Flocks and others (1955) introduced the term "phakolytic glaucoma" for cases in which glaucoma resulted from leakage of lens matter into the anterior chamber (Irvine and Irvine, 1952;Schofield, I957;Fenton and de Buen, 1964). The condition mostly occurs in cases of hypermature cataract in which the capsule is thinned or ruptured posteriorly (Flocks and others, 1955;Schofield, 1957).…”

Section: Discussionmentioning

confidence: 99%

Prognosis in spontaneous phakolytic glaucoma.

Sood¹,

Sofat²,

Chandel³

et al. 1972

British Journal of Ophthalmology

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ExaminationThe left eye was found to have moderate circumcorneal congestion; the cornea was oedematous and hazy, and the anterior chamber was deep and contained turbid aqueous but no keratic precipitates. The pupil was moderately dilated and pupillary reactions were well preserved though somewhat sluggish. The iris pattern was normal and the hypermature cataractous lens was in situ. Visual acuity was reduced to perception of light with inaccurate projection in the nasal quadrant. The ocular tension was raised to 58 mm. Hg (Schiotz). Treatment A clinical diagnosis of phakolytic glaucoma was made and the patient was given acetazolamide and oral corticosteroids. This gave considerable subjective relief but the cornea continued to be oedematous with aqueous flare +, and intraocular pressure of 40 mm. Hg.Paracentesis was done on April 2 and repeated on April 8, followed by upper pole combined intracapsular cataract extraction (sector iridectomy) with forceps on April 9. Result Postoperative recovery was uneventful and the patient was discharged on April I7. At his last visit on July 17, 197I, the visual acuity had improved to 6/I2 with +8 D sph., + i D cyl., axis Io0.Case 2, a 56-year-old Hindu male, came to the out-patients department on March 9, I97I, with the complaint of headache and severe pain in the left eye of 4 days' duration. At previous examinations he had been found to have a mature cataract in this eye for the last 8 years, and this had become hypermature a year earlier.

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Lens-Induced Uveitis and Glaucoma*

Cited by 37 publications

References 0 publications

Cytological diagnosis of phacolytic glaucoma utilizing millipore filtration of the aqueous.

Cytological diagnosis of phacolytic glaucoma utilizing millipore filtration of the aqueous.

Corneal edema associated with degenerating Soemmering ring cataract: Clinical-pathologic correlation

Prognosis in spontaneous phakolytic glaucoma.

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