Swollen lens cortical granules in the anterior chamber

Introduction Lens granular glaucoma: history of cataract surgery or anterior chamber of crystalline in vitro injury, the anterior chamber is still open, the room angle is still open, the aqueous humor flashes significantly, the anterior chamber contains a large amount of swelling, and the lens of the cortex is healthy and contains a small amount of large macrophages. And small white blood cell sputum, visible anterior adhesion around the iris, lens granular glaucoma due to trauma or lens surgery, the lens cortex is scattered in the anterior chamber, blocking the anterior chamber angle, obstructing the outflow of aqueous humor, causing elevated intraocular pressure. When the epithelial cells reach the equator, they continue to stretch, bend, and move into the lens to become lens fibers.

Cause

In the lens granular glaucoma, due to trauma or lens surgery, the lens cortex is scattered in the anterior chamber, blocking the anterior chamber angle, obstructing the outflow of aqueous humor, causing an increase in intraocular pressure.

an examination

Related inspection

intraocular pressure

(1) Recent history of ocular trauma or extracapsular cataract extraction.

(2) suffering from eye pain, blurred vision, red eyes, and tears. photophobia.

(3) Increased intraocular pressure.

(4) Conjunctival hyperemia and corneal edema.

(5) visible white lens cortical fragments in the anterior chamber. The anterior chamber water cells and flash positive.

(6) The anterior chamber angle is an open angle, and there may be a retention of the lens cortex.

(7) In the case of trauma, the lens capsule is ruptured.

(8) Cytoplasmic granules and macrophages can be seen in aqueous cytology.

(9) Checking the optic nerve head, according to the size of the depression, it can be estimated that the patient's tolerance to intraocular pressure rises.

Differential diagnosis

Differential diagnosis of swollen lens cortical granules in the anterior chamber:

(1) Infectious endophthalmitis: obvious intraocular inflammation, but intraocular pressure can be normal.

(B) lens cortical allergic glaucoma: severe chronic granulomatous inflammation after a period of cataract surgery.

(C) lens-soluble glaucoma: often occurs in over-mature cataracts.

(D) cataract expansion secondary to glaucoma: the anterior chamber is evenly shallow.

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