As the lens thickens in the anterior–posterior dimension it can cause pupillary block and induce secondary angle-closure glaucoma, or it can physically push the iris forward and thus cause shallowing of the anterior chamber. Often, the patient presents with a red, painful eye and a history of vision changes as a result of cataract formation prior to the acute event (Fig 5-26). The cornea may be edematous, and gonioscopy reveals a closed anterior chamber angle. Initial management includes medical treatment to lower the IOP. The condition may respond to laser iridotomy, but definitive treatment consists of cataract extraction.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.