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April 1963

Phacoanaphylactic Endophthalmitis: An Unusual Mechanism for Glaucoma Secondary to Hypermature Lens

Author Affiliations

Washington, D.C.
Former Fellow in Ophthalmic Pathology, National Institute of Neurological Diseases and Blindness, United States Public Health Service, at Armed Forces Institute of Pathology, Washington 25, D.C. Present address: Hunterdon Medical Center, Flemington, N.J.; From the Registry of Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington 25, D.C.

Arch Ophthalmol. 1963;69(4):473-475. doi:10.1001/archopht.1963.00960040479009

Glaucoma related to hypermaturity of the lens is usually of the phacolytic type.1 In such cases, histiocytes laden with liquefied lens cortex (Morgagnian fluid) which has escaped through an intact lens capsule accumulate in the anterior chamber angle and obstruct the exit pathway. In the present case a different mechanism is involved in the production of glaucoma.

A 71-year-old white woman was observed to have a hypermature cataract and secondary glaucoma in her right eye. The eye was blind and painful and had keratoiritis, hypopyon, and a high tension. Enucleation was performed. The left eye was aphakic, with 20/30 vision and an intraocular pressure of 18.5 mm. Hg.

On histologic examination purulent exudate was observed in the anterior chamber (Fig. 1). There were broad peripheral anterior synechiae and posterior synechiae. It is noteworthy that the corneal endothelium had migrated around the pseudoangle onto the anterior iris surface (Fig. 2)

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