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CASE REPORT
Rare atypical presentation of phacolytic glaucoma as non-resolving microbial keratitis with endophthalmitis
  1. Rinky Agarwal,
  2. Manasi Tripathi,
  3. Anuja Patil and
  4. Namrata Sharma
  1. Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Rinky Agarwal, rinky.1990{at}gmail.com

Abstract

Phacolytic glaucoma (PLG) is a rare complication of hypermature senile cataract. Delayed presentation of PLG may make its diagnosis and management difficult and worsen its prognosis. A woman aged 75 years complaining of sleep disturbing pain and inaccurate projection of rays oculus dextrus (OD) was referred to our centre for management of non-resolving microbial keratitis with endophthalmitis. Ultrasound biomicroscopy revealed 360° peripheral anterior synechiae, swollen crystalline lens and hyperechoic granules filling anterior chamber. A diagnosis of PLG and lens-induced uveitis was made and cataract was extracted after control of intraocular pressure (IOP). The patient was left aphakic. There was complete resolution of pain after surgery and at 3 months follow-up the IOP was controlled without any antiglaucoma medications. Rarely, secondary corneal opacification from long-standing pathological changes in PLG may mimic non-resolving microbial keratitis with endophthalmitis and requires a high index of suspicion for appropriate diagnosis and management.

  • anterior chamber
  • glaucoma
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Footnotes

  • Contributors RA: manuscript writing; MT: data collection; AP: patient care; NS: supervision and manuscript editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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