Dineshkanth Vudayana1, Lakshmi Sativada2, Pavani Jerry3, Padmaraju Kolluru4
BACKGROUND
Lens induced glaucomas are common in India. There were different types of lens
induced glaucomas based on clinical features and morphological features. This
study was undertaken to evaluate the various characteristics and presentations of
glaucomas, to define the risk factors and to evaluate as to how they influence the
post-operative visual acuity, intra ocular pressure, inflammation and optic disc
changes.
METHODS
This longitudinal study included 90 cases of lens induced glaucoma admitted in
the ophthalmic wards of the Great Eastern Medical School and Hospital,
Srikakulam, during the period March 2018 to March 2020. All consecutive patients
diagnosed as lens induced glaucoma on the basis of clinical symptoms and signs
were included. At presentation, visual acuity, IOP, inflammation including corneal
changes were recorded, which were repeated after institution of medical line of
treatment and postoperatively patients were followed up regularly at 2, 4 and 6
weeks intervals and the same parameters were evaluated including optic disc
changes.
RESULTS
Occurrence of lens induced glaucoma in the hospital during the study period was
1.72 %. The mean age of presentation of various types of glaucomas was 60.57
years and the female to male ratio was 2:1. The most frequent type of lens induced
glaucoma was phacomorphic glaucoma (70 %). In 34.4 % patients best corrected
visual acuity was found to be better than 6 / 18. In 14.4 % of cases, visual acuity
was found be worse than 6 / 60. In patients who presented with symptoms of less
than two weeks duration, better visual acuity of 6 / 12 or more was noted (76.2
%, P < 0.01). In 60 % patients who presented with IOP levels of less than 35
mmHg, better visual acuity of 6 / 12 or more was noted in 76.2 %. The mean IOP
noted in patients with symptoms of 2 to 4 weeks duration was found to be 40.33
± 9.36 mmHg. Inflammation was more severe in patients who were symptomatic
for more than 2 weeks (37.50 %, P < 0.05) and also in cases with IOP more than
35 mmHg (40 %). Optic disc of the presented eye was found to be damaged in
35.5 % of cases and in patients presenting with symptoms of more than 2 weeks’
duration it was 62.5 % (P < 0.01).
CONCLUSIONS
Presentation with intraocular pressure value greater than 35 mm of Hg and with
symptoms of more than two weeks would result in severe inflammation further
affecting the cornea and causing optic nerve damage which would ultimately
jeopardize vision. This can be prevented by early presentation and regular
screening of people above 60 years of age.
