A 70-year-old man with a hypermature cataract presents with painful vision loss, corneal oedema, deep anterior chamber, and IOP of 48 mmHg. Gonioscopy shows an open angle filled with floating white particles and macrophages. What is the mechanism of this glaucoma?
- A Anterior displacement of the lens-iris diaphragm causing pupillary block
- B Granulomatous inflammation triggered by lens antigen deposition in the angle
- C Obstruction of the trabecular meshwork by liquefied lens proteins and lens protein-laden macrophages ✓
- D Forward movement of the swollen cataractous lens causing angle closure
Correct answer: C. Obstruction of the trabecular meshwork by liquefied lens proteins and lens protein-laden macrophages
Explanation
Phacolytic glaucoma occurs when a hypermature cataract leaks liquefied cortical proteins through an intact capsule; these proteins and macrophages engorged with lens matter obstruct the trabecular meshwork in an open angle. Option A describes pupillary block glaucoma, option B describes phacoantigenic uveitis, and option D describes phacomorphic angle closure, each a separate entity.
Reference: Parsons' Diseases of the Eye, 23rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.