Abstract
The crystalline lens is implicated as a causative element in producing several forms of glaucoma. Etiologically they represent a diversity in the presentation of the glaucomatous process. These conditions include glaucoma related to: lens dislocation (ectopia lentis), lens swelling (intumescent cataract), classical pupillary block, aqueous misdirection - ciliary block, phacoanaphylaxis, lens particle, and phacolytic glaucoma. The management of elevated intraocular pressure often requires altering the intraocular relationship of anatomic structures surrounding the lens or lens removal. We will review the entities that produce these lens-induced glaucomatous conditions and suggest a rational approach to their diagnosis and treatment.
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References
Mapstone R. Outflow changes in normal eyes after closed-angle glaucoma. Br J Ophthalmol 1977; 61: 637–640.
Lowe R. Causes of shallow anterior chamber in primary angle-closure glaucoma. Am J Ophthalmol 1969; 67: 87–93.
Lowe R. Anterior lens displacement with age. Br J Ophthalmol 1970; 54: 17–121.
Lowe R. Aetiology of the anatomical basis for primary angle-closure glaucoma. Br J Ophthalmol 1970; 54: 161–169.
Markowitz S, Morin D. Angle-closure glaucoma: Relation between lens thickness, anterior chamber depth and age. Can J Ophthalmol 1984; 19: 300–302.
Lowe R, Clark B. Radius of curvature of the anterior lens surface. Br J Ophthalmol 1973; 57: 471–474.
Fontana S, Brubaker R. Volume and depth of the anterior chamber in the normal aging human eye. Arch Ophthalmol 1980; 98: 1803–1808.
Galin M, Obstbaum S. Diagnosis and treatment of angle closure glaucoma, symposium on glaucoma. Transactions of the New Orleans Academy of Ophthalmology (CV Mosby Co), 1975: 221–237.
Mapstone R. Closed-angle glaucoma: Theoretical considerations. Br J Ophthalmol 1974; 58: 36–40.
Mapstone R. Angle closure mechanisms in glaucoma. Seminars in Ophthalmology 1986; 1: 35–40.
Mapstone R. Acute shallowing of the anterior chamber. Br J of Ophthalmol 1981; 65: 446–451.
Epstein DL, ed. Chandler and Grant's glaucoma, 3rd ed. Philadelphia: Lea & Febiger, 1986.
Ritch R. Shields MB, Krupin T. The glaucomas. St. Louis: CV Mosby Co, 1989.
Mapstone R, Clark C. Diurnal variations in the dimensions of the anterior chamber. Arch Ophthalmol 1985; 1485–1486.
Spalton DJ, Hitchings RA, Hunter PA. Atlas of clinical ophthalmology. JB Lippincott and Co, 1984.
Maddalena M. Transient myopia associated with acute glaucoma and retinal edema. Arch Ophthalmol 1968; 80: 186–188.
Saari KM. Acute glaucoma in hemorrhagic fever with renal syndrome (Nephropathia Epidemica). Am J Ophthalmol 1976; 81: 455–461.
Kramer P, Ritch R. The treatment of acute angle-closure glaucoma revisited. Annals Ophthalmol 1984; 16, 1101–1103.
Ullman S, Wilson RP et al. Bilateral angle closure glaucoma in association with the acquired immune deficiency syndrome. Am J Ophthalmol 1986; 101, 419–424.
Ueda N, Ogino N. Angle-closure glaucoma with pupillary block mechanism in cicatricial retinopathy of prematurity. Ophthalmologica (Basel) 1988; 196: 15–18.
Hoskins HD, Kass M. Becker and Shaffer's diagnosis and therapy of the glaucomas, 6th ed. St. Louis: CV Mosby Co, 1989.
Ritch R. Argon laser treatment for medically unresponsive attacks of angle-closure glaucoma. Am J Ophthalmol 1982; 94: 197–204.
Koster HR, Liebmann JM et al. Acute-closure glaucoma in a patient with AIDS successfully treated with argon laser peripheral iridoplasty. Ophthalmic Surgery 1990; 21: 501–502.
Epstein DL. Diagnosis and management of lens-induced glaucoma. Ophthalmology 1982; 89: 229–230.
Simmons R. Malignant glaucoma. Br J Ophthalmol 1972; 56: 263–272.
Ellis P. Malignant glaucoma occurring 16 years after successful filtering surgery. Annals Ophthamol 1984; 16: 177–179.
Mills DW, Willis NR. Malignant glaucoma: The long and short of it. Can J Ophthalmol 1978; 13: 86–88.
Hardten DR, Brown JD. Malignant glaucoma after Nd: YAG cyclophotocoagulation. Am J Ophthalmol 1991; 111: 245–247.
Weiss IS, Dieter PD. Malignant glaucoma syndrome following retinal detachment surgery. Annals Ophthalmol 1974; October: 1099–1104.
Disclafani M, Liebmann J et al. Malignant glaucoma following argon laser release of scleral flap sutures after trabeculectomy. Am J Ophthalmol 1989; November: 597–598.
Robinson A, Prialnic M et al. The onset of malignant glaucoma after prophylactic laser iridotomy. Am J Ophthalmol 1990; 110: 95–96.
Levene R. A new concept of malignant glaucoma. Arch Ophthalmol 1972; 87: 497–506.
Phelps CD. Angle-closure glaucoma secondary to ciliary body swelling. Arch Ophthalmol 1974; 92: 287–290.
Weiss DI, Shaffer RN. Ciliary block (malignant) glaucoma. Trans Am Acad Ophthalmol and Otolaryngol 1972; 76: 450–461.
Schwartz AL, Anderson DR. ‘Malignant glaucoma’ in an eye with no antecedant operation or miotics. Arch Ophthalmol 1975; 93: 379–381.
Fanous S, Brouillette G. Ciliary block glaucoma: Malignant glaucoma in the absence of a history of surgery and of miotic surgery. Can J Ophthalmol 1983; 18: 302–303.
Luntz MH, Rosenblatt M. Malignant glaucoma. Survey of Ophthalmol 1987; 32: 73–93.
Levene RZ. Current concepts of malignant glaucoma. Ophthalmic Surgery 1986; 17: 515–520.
Epstein DL. Experimental perfusions through the anterior and vitreous with possible relationships to malignant glaucoma. Am J Ophthalmol 1979; 88: 1078–1086.
Grant WM. Experimental aqueous perfusion in enucleated human eyes. Arch Ophthalmol 1963; 69: 783–801.
Chandler PA, Grant WM. Mydratic-cycloplegic therapy in malignant glaucoma. Arch Ophthalmol 1962; 68: 353–359.
Geyer O. et al. Malignant glaucoma after laser iridectomy. Brit J Ophthalmol 1990; 74: 576.
Romem M, Singer L. et al. Unusual course and long-term follow-up in malignant glaucoma. Annals Ophthalmol 1978; August: 1083–1085.
Herschler J. Laser shrinkage of the ciliary processes. Ophthalmology 1990; 87: 1155–1158.
Simmons RJ. Discussion of article ‘Laser shrinkage of the ciliary processes’. Ophthalmology 1990; 87: 1158–1159.
Shaffer RN. The role of vitreous detachment in aphakic and malignant glaucoma. Trans Am Acad Ophthalmol and Otolaryng. 1954; March–April: 217–231.
Chandler PA. A new operation for malignant glaucoma: A preliminary report. Trans Am Ophthalmol Soc 1964; 62: 408–424.
Chandler PA, Simmons RJ et al. Malignant glaucoma medical and surgical treatment. Am J Ophthalmol 1968; 66: 495–502.
Momoeda S, Hayashi H, et al. Anterior Pars Plana Vitrectomy for Malignant Glaucoma. Jpn J Ophthalmol 1983; 27(1): 73–9.
Jay B. Glaucoma associated with spontaneous displacement of the lens. Br J Ophthalmol 1972; 56: 258–262.
McCulloch C. Hereditary lens dislocation with angle-closure glaucoma. Can J Ophthalmol 1979; 14: 230–234.
Nelson LB, Maumenee IH. Ectopia lentis. Survey of Ophthalmol 1982; 27: 143–160.
Townes PL. Ectopia lentis et pupillae. Arch Ophthalmol 1976; 94: 1126–1128.
Cross HE. Ectopia lentis et pupillae. Am J Ophthalmol 1979; 88: 381–384.
Goldberg MF. Clinical manifestations of ectopia lentis in 16 patients. Ophthalmology 1988; 95: 1080–1087.
Goldberg MF. Cytological diagnosis of phacolytic glaucoma utilizing millipore filtration of the aqueous. Br J Ophthalmol 1967; 51: 847–853.
Malbran ES, Coxatto JO et al. Genetic spontaneous late subluxation of the lens. Ophthalmology 1989; 96: 223–229.
Weingarten JB, Smoth LH. Cecil's Textbook of Medicine, 18th Ed WB Saunders and Co. 1988.
Dietz HC, Cutting GR et al. Marfan syndrome caused by a recurrent de novo missense mutation in the fibrillin gene. Nature 1991; 352: 337–339.
Burian HM, van Noorden GK, Ponseti IV. Chamber angle anomalies in systemic connective tissue disorders. Arch Ophthalmol 1960; 64: 671–680.
Cross HE, Jensen AD. Ocular manifestations in the Marfan syndrome and homocystinuria. Am J Ophthalmol 1973; 75: 405–420.
Lieberman TW, Podos SM et al. Acute glaucoma, ectopia lentis and homocystinuria. Am J Ophthalmol 1966; 1966: 252–255.
Jensen AD, Cross HE, Paton D. Ocular complications in the Weill-Marchesani syndrome. Am J Ophthalmol 1974; 77: 261–269.
Feiler-Ofry V, Stein R, Godel V. Marchesani's syndrome and chamber angle anomalies. Am J Ophthalmol 1968; 65: 862–866.
McGavic JS. Weill-Marchesani syndrome. Am J Ophthalmol 1966; 62: 820–823.
Johnston SS. Pupil-block glaucoma in homocystinuria. Br J Ophthalmol 1968, 52, 251–256.
Obstbaum SA. In: Collins, JF, ed., Handbook of Clinical Ophthalmology, New York: Masson Publishing, 1982: 334.
Ritch R, Shields MB. The secondary glaucomas. St. Louis: CV Mosby Co, 1982.
Flocks M, Littwin CS, Zimmerman LE. Phacolytic glaucoma: A clinicopathological study of 138 cases of glaucoma associated with hypermature cataract. Arch Ophthalmol 1955; 54: 37–45.
Irvine SR, Irvine Jr, AR. Lens induced uveitis and glaucoma, part I: Endophthalmitis phaco-anaphylactica. Am J Ophthalmol 1952; 35: 177–186.
Yanoff M, Scheie HG. Cytology of human lens aspirate: Its relationship to phacolytic glaucoma and phacoanaphylactic endotphthalmitis. Arch Ophthalmol 1968; 80: 166–170.
Smith ME, Zimmerman LE. Contusive angle recession in phacolytic glaucoma. Arch Ophthalmol 1965; 74: 799–804.
Epstein DL, Jedziniak JA, Grant WM. Identification of heavy molecular weight soluble protein in aqueous humor in human phacolytic glaucoma. Invest Ophthalmol Vis Sc 1978; 17: 398–402.
Epstein DL, Jedizniak J, Grant. Obstruction of aqueous outflow by lens particles and heavy molecular weight soluble proteins. Invest Ophthalmol Vis Sci 1978, 272.
Jedziniak JA, Kinoshita JH et al. On the presence and mechanism of formation of heavy molecular weight aggregates in human normal and cataractous lenses. Experimental Eye Research 1973; 15: 185–192.
Lane SS, Kopietz LA et al. Treatment of phacolytic glaucoma with extracapsular cataract extraction. Ophthalmology 1988; 95: 749–753.
Thach AB, Marak GE et al. Phacoanaphylactic endophthalmitis: A clinicopathologic review. International Ophthalmol 1991; 15: 271–279.
Perlman EM, Albert DM. Clinically unsuspected phacoanaphylaxis after ocular trauma. Arch Ophthalmol 1977; 95: 244–246.
Duke-Elder, Sir S., Perkins ES. System of ophthalmology, Vol. 9: Diseases of the uvea. St. Louis: CV Mosby Co, 1966.
Marak GE et al. Experimental lens-induced granulomatous endophthalmitis in: Modern Problems in Ophthalmology, Vol. 16: 75–79 Basel: Karger, 1976.
Chishti M, Henkind P. Spontaneous rupture of the anterior lens capsule (Phacoanaphylactic Endophthalmitis). Am J Ophthalmol 1970; 69: 264–270.
Allen JC. Sympathetic uveitis and phacoanaphylaxis. Am J Ophthalmol 1967; 63: 280–283.
Easom HA, Zimmerman LE. Sympathetic ophthalmia and bilateral phacoanaphylaxis. Arch Ophthalmol 1964; 72: 9–15.
Riise P. Endophthalmitis phacoanaphylactica. Am J Ophthalmol 1965; 60: 911–915.
Wohl LG et al. Pseudophakic phacoanaphylactic endophthalmitis. Ophthalmic Surgery 1986; 17: 234–237.
Ishikawa Y, Kawata Y Ishikawa Y. Three cases of endophthalmitis phacoanaphylactica in the fellow eye after cataract extraction. Folia Ophthalmol Japan 1977; 28: 1260–1265.
Apple DJ, Mamalis N et al. Phacoanaphylactic endophthalmitis associated with extracapsular cataract extraction and posterior chamber intraocular lens. Arch Ophthalmol 1984; 102: 1528–1532.
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Ellant, J.P., Obstbaum, S.A. Lens-induced glaucoma. Doc Ophthalmol 81, 317–338 (1992). https://doi.org/10.1007/BF00161770
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DOI: https://doi.org/10.1007/BF00161770