Sequelae of neglected senile cataract
AbstractCataract is the most common cause of blindness in the world. An attack of phacolytic and phacomorphic glaucoma as a result of neglected cataract constitutes a medical emergency that must be addressed immediately. Ocular emergencies such as these is challenging for the surgeon with guarded or poor prognosis. We describe the presentation, management and prognosis of three cases of phacomorphic and phacolytic glaucoma. All three patients underwent aggressive management of intraocular pressure. Despite successful cataract operation with implantation of intraocular lens, there was only mild improvement of the vision. Optic nerve and pupil functions were permanently affected following the insult. Phacomorphic and phacolytic glaucoma present a very challenging problem to the surgeon with poor visual outcome. Public health education and awareness are important and health workers should encourage patients with cataract to seek early treatment for better prognosis.
Bjorn T. The global initiative for the elimination of avoidable blindness. Community Eye Health Journal.1998;11:1-3
Zainal M, Ismail SM, Ropilah AR, Elias H et al. Prevalence of blindness and low vision in Malaysian population. Results from National Eye Survey 1996.Br J Ophthalmol.2002;86:951-6.
Pradhan D, Hennig A, Kumar J, Foster A. A prospective study of 413 cases of lens-induced glaucoma in Nepal. Indian J Ophthalmol. 2001;49:103–7.
Goh PP, Shamala R, Rajalakshmi G, Ronald AD. The 3rd Report of the National Cataract Surgery Registry 2004. National Cataract Surgery Registry,Malaysia;2004.
Ho T, Law N M, Goh L G, Yoong T. Eye diseases in the elderly in Singapore. Singapore Med J 1997; 38:149-55.
Gressel MG. Lens-induced glaucoma. Duane’s Clinical Ophthalmology. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 1998. 554.
Tomey KF, al-Rajhi AA. Neodymium: YAG laser iridotomy in the initial management of phacomorphic glaucoma. Ophthalmology. 1992;99:660–5.
Rosenbaum, J. T., Samples, J. R., Seymour, B., Langlois, L, et al. Chemotactic activity of lens proteins and the pathogenesis of phacolytic glaucoma. Arch Ophthalmol. 1987; 105(11), 1582.
Ramakrishanan R, Maheshwari D, Abdul Kader M, Singh R, et al.Visual prognosis, intraocular pressure control and complications in phacomorphic glaucoma following manual small incision cataract surgery. Indian J Ophthalmol. 2010; 58(4): 303–6.