Phacolytic Glaucoma Secondary to Mature Senile Cataract in an Elderly Female: A Case Report

Phacolytic glaucoma is a rare type of secondary open-angle glaucoma caused by leakage of high-molecular-weight lens proteins through an intact capsule of a mature/hypermature cataract. It is most frequently seen in elderly patients who defer cataract surgery and, if not recognised and managed promptly, can lead to permanent visual impairment. A 61-year-old woman presented with severe ocular pain and redness in the left eye for 20 days, along with progressive visual decline over the past 1.5 years. Detailed slit-lamp and fundus examinations revealed phacolytic glaucoma associated with a mature senile cataract in the left eye, while the right eye showed pseudophakia with Posterior Capsular Opacification (PCO). Initial management focused on controlling Intraocular Pressure (IOP) and inflammation using topical along with systemic antiglaucoma medications. Definitive treatment was achieved through cataract extraction with Posterior Chamber Intraocular Lens (PCIOL) implantation, following which the IOP normalised and ocular pain resolved. However, the final visual outcome remained guarded due to prolonged period of raised IOP prior to intervention. This case highlights diagnostic and therapeutic challenges of phacolytic glaucoma, particularly in developing regions where delayed cataract surgery is common. Early diagnosis, prompt medical stabilisation, and timely surgical removal of cataract are essential to prevent irreversible optic nerve damage.