Capsular glaucoma belongs to the group of secondary open-angle buttercups and develops due to the accumulation of exfoliating (pseudoexfoliating) material in the anterior chamber angle.

Capsular glaucoma(otherwiseglaucoma in the course of pseudo-exfoliation syndrome-pseudoexfoliation , PEX ) usually affects people over 60. Often the lesions only affect one eye, although they may later develop in the other eye as well. The probability of developing glaucoma in the course of pseudoexfoliation syndrome is about 40% in 10 years.

Capsular glaucoma: causes

Pseudo-exfoliation syndrome is a deposition of characteristic, abnormal amyloid (protein) material in the structures of the anterior chamber of the eye. It is easiest for a doctor to see it on the front surface of the lens, with a dilated pupil. These deposits take the appearance of a centrally located white disc. Changes also appear on the pupillary edge of the iris, lens fibrils, anterior vitreous surface, ciliary processes, corneal endothelium and in the anterior chamber angle. Deposition on the ciliary fibrils may weaken them and contribute to spontaneous subluxation of the lens. In such cases, complications from cataract surgery may occur more frequently.

The build-up of pseudoexfoliation material in the trabeculae structures causes the trabeculae, which drains the aqueous humor from the eye, to appear somewhat "covered with dandruff" and by an increased amount of scattered dye. The filtration angle may narrow at times.

The fibrous material deposited in the trabeculae of the infiltration angle mechanically clogs the ways that allow the aqueous humor to drain out of the eye and causes an increase in eye pressure.

Glaucoma - what is it manifested?

capsular glaucoma: symptoms

With prolonged high pressure, the optic nerve is damaged. If the pressure is not very high, it usually does not give any symptoms, so in this type of glaucoma, it is most often diagnosed by a random visit to the patient.of an ophthalmologist, most often because of the deterioration of vision that is caused by cataracts forming rather than glaucoma. If a patient does not visit an ophthalmologist because he is not bothered by poor vision, glaucoma may develop unnoticed and may be detected only in advanced stages, when the patient decides to undergo cataract surgery and goes to the ophthalmologist. That is why regular ophthalmological check-ups are so important for the elderly, at least once a year, preferably twice a year.

Capsular Glaucoma: Research

In patients diagnosed with pseudoexfoliation syndrome, checks should be more frequent. If capsular glaucoma is suspected, the patient should undergo diagnostic tests included in the gold standard. It is:

  • HRT optic nerve assessment
  • assessment of the GDx retinal nerve fiber layer and the GCL retinal ganglion cell layer
  • AS-OCT drainage angle assessment
  • field of view examination, preferably in FDT technology

Capsular glaucoma: prognosis and treatment

The prognosis for this type of glaucoma is worse than for primary glaucoma due to the fact that eye pressures are higher and fluctuate more. Treatment is also less satisfactory due to lower drug efficacy and greater inflammatory reactions following surgical treatment.

Treatment of capsular glaucoma involves lowering intraocular pressure with medications in the form of eye drops, laser treatments, cataract surgery and anti-glaucoma treatments.

About the authorBarbara Polaczek-Krupa, MD, PhD, specialist in eye diseases, Centrum Opulystowa Targowa 2, Warsaw

Dr. Barbara Polaczek-Krupa, MD, initiator and founder of the T2 Center. She specializes in modern diagnostics and treatment of glaucoma - this was also the subject of her doctoral thesis defended with honors in 2010, Dr. med. Polaczek-Krupa has been gaining experience for 22 years, since she started working at the Ophthalmology Clinic of the CMKP in Warsaw, with which she was tied in the years 1994-2014. During this period, she obtained two degrees of specialization in ophthalmology and the title of doctor of medical sciences. In the years 2002-2016 she worked at the Institute of Glaucoma and Eye Diseases in Warsaw, where she gained medical knowledge and experience by consulting patients from all over Poland and abroad. The Postgraduate Medical Education Center is a lecturer at courses and training for doctors specializing in ophthalmology and primary he alth care. He is the author or co-author of numerous publications in scientific journals. Member of the Polish Society of Ophthalmology (PTO) and the European SocietyGlaucoma (EGS).

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Eye diseases and vision disorders