The lens induced glaucoma patient is typically elderly, with a history of cataracts. In all of these cases, the glaucoma is typically very symptomatic with pain and redness in the involved eye, and cells and flare in the anterior chamber. Frequently, an advanced cataract in the involved eye severely reduces vision. It's characterized by acute onset of pain and redness and IOPs often of 35mm Hg or greater. There is liquefaction of the lens nucleus and cortex, and attenuation of the capsule with the release of lens proteins into the anterior chamber.
Macrophages engulf the lens proteins, become bloated, and block trabecular outflow.
The angle remains open, though in some cases peripheral anterior synechiae may develop. The mechanism of lens particle glaucoma resembles that of phacolytic glaucoma, except that there is a history of surgery or trauma that releases the lens proteins into the anterior chamber and initiates a macrophage-driven inflammatory reaction. The angle remains open. This is a chronic uveitis that occurs one to 14 days following cataract extraction or lens trauma. This mechanism is similar to the previous two types of glaucoma, except that inflammatory cells are not limited to macrophages.