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Case Reports in Ophthalmological Medicine
Volume 2011, Article ID 850919, 3 pages
http://dx.doi.org/10.1155/2011/850919
Case Report

Unusual Presentation of Phacolytic Glaucoma: Simulating Microbial Keratitis

1Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Orissa 751024, India
2Miriam Hymen Children’s Eye Care Center, L V Prasad Eye Institute, Bhubaneswar, Orissa 751024, India
3Dalmia Ophthalmic Pathologic Services, L V Prasad Eye Institute, Hyderabad, Andra Pradesh 500034, India

Received 8 October 2011; Accepted 31 October 2011

Academic Editors: E. B. Rodrigues and S. A. Vernon

Copyright © 2011 Srikant Kumar Sahu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The differential diagnoses for phacolytic glaucoma are acute angle closure glaucoma, open angle glaucoma with uveitis, neovascular glaucoma, and glaucoma secondary to trauma. We report an unusual case where the dislocated cataractous lens firmly adherent to the corneal endothelium evoked a cellular reaction similar to phacolytic glaucoma but clinically appeared like a deep corneal abscess. The 73-year-old lady presented with severe photophobia, pain, and redness in the left eye for two months despite being on antibiotics and antifungals. Anterior chamber wash revealed a cataractous lens buried within the infiltrate, which was removed and sent for histopathological examination. Postoperatively she was treated with topical ofloxacin, homatropine, dorzolamide, timolol, and tapering dose of steroids. Histological confirmation of inflammation, histiocytic response, and giant cells around the lens material confirmed the ongoing phacolytic process. Photophobia, pain, and redness subsided following removal of the lens and surrounding cellular reaction. At her last visit, four months after surgery, she was comfortable.