Lens-Particle Glaucoma

• Lens-Particle Glaucoma Overview
• Lens-Particle Glaucoma Causes
• Lens-Particle Glaucoma Symptoms
• When to Seek Medical Care
• Questions to Ask the Doctor
• Exams and Tests
• Lens-Particle Glaucoma Treatment
• Self-Care at Home
• Medical Treatment
• Medications
• Surgery
• Next Steps
• Follow-up
• Outlook
• Support Groups and Counseling
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Lens-Particle Glaucoma Overview

The crystalline lens (commonly referred to as the lens) is the natural lens of the eye, located behind the pupil. The lens consists of a soft outer cortex and a harder nucleus in the center. See Image 1. The lens may cause lens-induced glaucomas, which are typically associated with abnormally high eye pressure and possible vision loss. Lens-induced glaucomas may be either open-angle glaucomas or angle-closure glaucomas.

• Open-angle, lens-induced glaucomas include lens-particle glaucoma, phacolytic glaucoma, and phacoanaphylaxis.
  
  
• Angle-closure, lens-induced glaucomas include phacomorphic glaucoma and ectopia lentis.

Lens-particle glaucoma can occur when fragmented lens debris is retained inside the eye following surgery or injury/trauma.

Characteristically, large lens pieces spontaneously fragment further into small (sometimes invisible) particles that eventually migrate into the anterior chamber, where they obstruct the flow of fluid (called aqueous humor) from the eye. This obstruction in the outflow of fluid results in an increase in the pressure inside the eye, called intraocular pressure (IOP).

Eye pressure is measured in millimeters of mercury (mm Hg). Although every individual person is different, normal eye pressure typically ranges from 10-20 mm Hg. When your pressure is higher than 20-22 mm Hg, you may be at an increased risk for developing glaucoma.

High pressure inside the eye is caused by an imbalance in the production and drainage of aqueous humor. In the case of lens-particle glaucoma, the channels (called trabecular meshwork) that normally drain aqueous humor from inside the eye are blocked by microscopic lens material. More aqueous humor is continually being produced but cannot be drained adequately because of the blocked drainage channels. This results in an increased amount of fluid inside the eye, thus raising the pressure. See Image 2.

High pressure inside the eye can damage the optic nerve and can result in permanent vision loss. Although high pressure inside the eye, optic nerve damage, and vision loss are not all required to diagnose glaucoma, a diagnosis of glaucoma is often determined when all 3 criteria are present.

In the United States, the exact prevalence rate of lens-particle glaucoma has not been reported. Lens-particle glaucoma can affect men and women of any race. All ages can be affected, ranging from infancy (particularly in cases of congenital cataract surgery) to late adulthood. Lens-particle glaucoma probably occurs most commonly in elderly persons as a complication of cataract surgery; however, its occurrence following routine surgery is rare. Lens-particle glaucoma tends to develop more often as a result of injury/trauma that directly damages the lens.