• Fredy Ciputra 082281009629
Keywords: phacomorphic glaucoma, cataract, intumecent, glaucoma, secondary glaucoma, lens-induced glaucoma


Phacomorphic glaucoma is secondary angle-closure glaucoma caused by thickening of the lens. Angle narrowing can occur slowly as cataract advances resulting in forward bowing of the iris caused by intumescent lens. Risk factors for phacomorphic glaucoma are age, gender, anterior chamber depth, axial length, and hypermetropia. Phacomorphic glaucoma is a clinical diagnosis that can be established simply by history and physical examination. Signs and symptoms experienced by patients with phacomorphic glaucoma, similar to other angle-closure glaucoma, are red eyes, pain, decreased visual acuity, increased IOP, corneal edema, anterior bowing of iris, narrow chambers and lens opacity as a sign of cataracts. The main treatment for phacomorphic glaucoma is cataract extraction, which can only be achieved after good control of IOP through drugs or laser. Early recognition of signs and symptoms of phacomorphic glaucoma and appropriate and prompt preoperative treatment greatly affect the course of surgery and the final visual outcome. Given that the COVID-19 pandemic has caused many people to delay getting their medical checkups, including cataracts checkups, the incidence of phacomorphic glaucoma may increase. This makes it important for clinicians to recognize phacomorphic glaucoma.


1. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: A review. JAMA. 2014;311(18):1901-1911.
2. Rijal AP, Karki DB. Visual outcome and IOP control after cataract surgery in lens induced glaucoma. Kathmandu Univ Med J. 2006;4(1):30-33.
3. American Academy of Ophthalmology. 2020. Basic and Clinical Science Course, Section 10: Glaucoma. China: American Academy of Ophthalmology, pp.169-171.
4. Kothari R, Tathe S, Gogri P, Bhandari A. Lens-induced glaucoma: The need to spread awareness about early management of cataract among rural population. ISRN Ophthalmol. 2013;2013:581727.
5. Laurenti K, Salim S. Lens induced glaucoma: diagnosis and management. Fekrat S, Scott I, editors. EyeNet Magazine. 2016;Oct:55-56.
6. Bhartiya S, Kumar HM, Jain M. Phacomorphic glaucoma: Evolving management strategies. J Curr Glaucom Pract. 2009 May-Aug;3(2):39–46.
7. Kaplowitz KB, Kapoor KG. An evidence-based approach to phacomorphic glaucoma. J Clinic Experiment Ophthalmol. 2012;S1:1-6.
8. Shah SS, Meyer JJ. Lens Induced Glaucoma. [Updated 2021 Oct 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
9. Lee JW, Lai JS, Yick DW, Tse RK. Retrospective case series on the long-term visual and intraocular pressure outcomes of phacomorphic glaucoma. Eye (Lond). 2010;24:1675–1680.
10. Kele? A, ?en E, Elgin U. Evaluation of biometric parameters in phacomorphic glaucoma and mature cataracts. Eur J Ophthalmol. 2021 May;31(3):1101-1106.
11. Fernández-Vigo JI, Fernández-Vigo JÁ, Macarro-Merino A, Fernández-Pérez C, Martínez-de-la-Casa JM, García-Feijoó J. Determinants of anterior chamber depth in a large Caucasian population and agreement between intra-ocular lens Master and Pentacam measurements of this variable. Acta Ophthalmol. 2016;94(2):e150-155.
12. Lee SJ, Lee CK, Kim WS. Long-term therapeutic efficacy of phacoemulsification with intraocular lens implantation in patients with phacomorphic glaucoma. J Cataract Refract Surg. 2010;36(5):783-789.
13. Lee JW, Lai JS, Lam RF, Wong BK, Yick DW, Tse RK. Retrospective analysis of the risk factors for developing phacomorphic glaucoma. Indian J Ophthalmol. 2011;59(6):471-474.
14. Senthil S, et al. Comparison of cataract surgery alone versus cataract surgery combined with trabeculectomy in the management of phacomorphic glaucoma. J Glaucoma. 2016;25(3):e209-e213.
15. Johnson SM. 2009. Cataract Induced Glaucoma: Phacolytic/Phacomorphic. In: Cataract Surgery in the Glaucoma Patient. New York: Springer, pp. 207-212.
16. Sowka J. Phacomorphic glaucoma: Case and review. Optometry. 2006;77(12):586-589.
17. Ramakrishanan R, Maheshwari D, Kader MA, et al. Visual prognosis, intraocular pressure control and complications in phacomorphic glaucoma following manual small incision cataract surgery. Indian J Ophthalmol. 2010;58:303–306
18. Gedar Totuk OM, Aykan U. The use of femtosecond laser-assisted capsulotomy is challenging in patients with phacomorphic glaucoma. J Refract Surg. 2017;33(5):355-356.
19. Kránitz K, et al. Femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma. J Refract Surg. 2013;29:645-648.
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