Lens-Particle Glaucoma

Lens-particle glaucoma may develop when fragments of the lens become dislocated during surgery or after an eye injury. The exact rate of lens-particle glaucoma – also called lens-induced glaucoma or ectopia lentis – in the U.S. is unknown.

It is thought to affect males and females of any race and most often the elderly as a rare complication of cataract surgery. Lens-particle glaucoma is assumed to develop more often due to an injury or head trauma that directly damages the lens.

The crystalline lens, commonly called the lens, is located behind the pupil and includes a soft outer area with a harder nucleus in the center. Tiny lens debris breaks into small, sometimes invisible, particles that eventually migrate into the anterior chamber. There, these bits of lens may be reabsorbed or flushed out.

If the pieces block drainage channels within the eye, it can cause elevated eye pressure, and later, glaucoma. High pressure inside the eye can damage the optic nerve and eventually result in blindness. Although high pressure inside the eye, optic nerve damage, and vision loss are not all required to diagnose glaucoma, a diagnosis of glaucoma is often determined when all three are present.

Evaluation

There are several tests to screen for lens-particle glaucoma:

  • Tonometry is used to measure the pressure inside the eye. Elevated eye pressure (also called intraocular pressure or IOP) in only one eye is characteristic of lens-particle glaucoma
  • The front of the eyes, including the cornea, anterior chamber, iris, and lens, are examined using a special microscope called a slit lamp. This shows whether inflammation is present and if any lens fragments are attached to the lens capsule.
  • Indirect ophthalmoscopy shows if any lens particles are located in the vitreous (inside of the eye).
  • Gonioscopy checks the drainage angle of the eye where the iris and the cornea come together. A special contact lens is placed on the eye to show whether the angles are open, narrowed, or closed. This test also rules out other conditions that could cause elevated eye pressure.
  • Ultrasound testing may be used to locate and measure lens debris.
  • Because optic nerve damage is usually a sign of glaucoma, each optic nerve is examined for any damage or abnormalities. This may require dilation of the pupils.
  • Imaging studies may be conducted to document the current health of the optic nerve and to measure changes over time.

Treatment

The high eye pressure that often comes with lens-particle glaucoma often responds to treatment with medicated eye drops.

If an ophthalmologist prescribes medicated eye drops to help lower your eye pressure, it is important to consistently follow the instructions. Not using the eye drops, or using the medicine sporadically, may result in even higher eye pressure, and eventually, permanent vision loss.

Surgery may be needed to remove the lens particles if your eye pressure doesn't respond to medicated eye drops.

With early and consistent treatment, the prognosis for lens-particle glaucoma is generally good and complications minimal.