Vision loss due to uncommon “red eye”: A case report

Phacolytic glaucoma is a rare complication induced by hypermature cataracts and may occasionally be encountered in some rural areas. It tends to be misdiagnosed and induces a risk of permanent vision impairment. PATIENT CONCERNS: A 63-year-old Uighur woman complained of redness and decreased vision in her right eye and was treated for endophthalmitis at a primary hospital before being referred to our hospital. DIAGNOSIS: On admission, the patient had weak light perception in the right eye, an intraocular pressure of 65 mmHg, and slit-lamp examination revealed swelling of the eyelids and significant injection of conjunctiva. The entire cornea was cloudy and edematous, whereas the aqueous humor was milky turbid. Cytological examination of the aqueous liquid confirmed the presence of lens protein-laden macrophages. A Morgagnian cataract was observed after anterior chamber irrigation. So the final diagnosis was phacolytic glaucoma. INTERVENTIONS: The patient received anterior chamber irrigation and extracapsular cataract extraction with intraocular lens implantation successively. OUTCOMES: Final visual acuity was limited to 6/120 due to secondary optic nerve damage. LESSONS: Phacolytic glaucoma can mimic endophthalmitis and tend to be misdiagnosed, causing permanent vision impairment. Improving awareness of phacolytic glaucoma and enhancing public health education regarding cataracts are ways to prevent phacolytic glaucoma and phacolytic glaucoma-related vision loss.