Case Report: Diagnosis and Management of Phacolytic Glaucoma

Introduction Phacolytic glaucoma is a secondary open-angle glaucoma that is caused by the leakage of lens proteins from a hypermature cataract. These lens proteins elicit an inflammatory response within the eye, resulting in trabecular meshwork outflow obstruction and a subsequent rise in intraocular pressure, which is often significant and comparable to that seen in acute angle-closure. Patients present with an acutely painful red eye and severely reduced vision. Case Report A 72-year-old African American man presented with complaints of an acutely painful red right eye with decreased vision. Clinical examination revealed significantly elevated intraocular pressure and an anterior chamber reaction in the presence of a hypermature cataract, leading to a diagnosis of phacolytic glaucoma. Initial treatment and management included topical aqueous suppressants and corticosteroids to lower the intraocular pressure and control inflammation, respectively, followed by prompt cataract extraction. Postoperatively, the patient’s visual acuity improved, and intraocular pressure normalized without the need for further treatment. Conclusion Phacolytic glaucoma is a rare form of lens-induced glaucoma that is typically diagnosed based on its clinical presentation. Patients have the best visual prognosis and outcomes with early intraocular pressure and inflammation control, followed by timely cataract surgery. Therefore, it is important that optometrists accurately identify this condition and initiate the appropriate treatment and referral process.