Cataract Surgery and Lens-Particle Glaucoma: 4 Things to Know

Glaucoma is a group of eye diseases that damage the optic nerve—the tissue that converts light into images and sends those images to your brain—through increased intraocular pressure. Lens-particle glaucoma is a type of glaucoma that can develop after you have surgery on your eyes, like cataract surgery. Here are four things you need to know about lens-particle glaucoma.

1. What causes lens-particle glaucoma?

To understand the cause of lens-particle glaucoma, you need to be familiar with the relevant structures of the eye. The lens is a transparent structure within your eye that helps to refract light as it enters your eye. Your lens is located right behind your iris and pupil. It's kept safe by a membrane called a lens capsule.

If this capsule gets damaged, the aqueous humor (the fluid in front of the lens) will hydrate the lens, which causes it to break down. Pieces of your lens will then be released into the anterior chamber of your eye, where they can block the release of fluids from your eyes. When the fluids can't drain normally, they get trapped inside the eye, and pressure builds up. The end result of this process is lens-particle glaucoma.

This process may begin if you suffer a penetrating or blunt force injury to your eye. It can also occur as a complication of eye surgeries like cataract removal. For example, if your surgeon didn't remove all of your lens during your cataract surgery, the remaining fragments can then cause lens-particle glaucoma. To protect your eyes, make sure to choose a cataract surgeon that has performed many of these procedures with success. The optometrist or ophthalmologist who diagnosed your cataracts can refer you to a trusted colleague for this procedure. 

2. What are the signs of lens-particle glaucoma?

Often, lens-particle glaucoma is asymptomatic, according to Medscape, but if your intraocular pressure and intraocular inflammation are severe, you may have eye pain or blurred vision. Since this condition often doesn't cause symptoms, you need to have your intraocular pressure checked regularly after cataract surgery. 

If you've had cataract surgery in the past, you should have your intraocular pressure checked at least every one to two years after age 35. Your optometrist may recommend a more frequent screening schedule if they think it's necessary.

3. How does lens-particle glaucoma differ from other types?

Like other types of glaucoma, lens-particle glaucoma occurs when the fluids inside your eye aren't able to drain properly, leading to high pressure inside the eye. However, it's also unique in a lot of ways.

Unlike other types of glaucoma, it occurs as a direct result of trauma to your eye. It's not related to your age, your race, or your medical history, while other types of glaucoma are. It's also not genetic, so if you develop lens-particle glaucoma, your family members don't need to worry that they'll also get it.

4. How is lens-particle glaucoma treated?

Other types of glaucoma can be treated with miotic eye drops, a type of medication that encourages drainage of fluids from the eyes, but these drops can't be used for people with lens-particle glaucoma. In people with lens-particle glaucoma, they can lead to synechia, which means that the iris gets stuck to either the cornea or the lens. Synechia can raise your intraocular pressure; this is why your optometrist won't give you the pressure-reducing drops that other glaucoma sufferers get.

Instead, you'll be given topical corticosteroids to help reduce your inflammation. Your optometrist will then monitor your eyes to make sure the lens material is absorbed. If the lens material doesn't absorb quickly, you'll need surgery to resolve your glaucoma. This surgery involves removing all of the remaining lens material.

Lens-particle glaucoma is a possible complication of cataract surgery. After your cataract surgery, you'll need to see your optometrist regularly to be screened for this type of glaucoma.