Pupillary Block
![Dislocation of a posterior chamber intraocular lens resulting in the formation of pupillary block glaucoma.](https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_200/public/media/images/2022-04/pupillary-block.jpeg?itok=DOdPH_8N 200w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_260/public/media/images/2022-04/pupillary-block.jpeg?itok=GzE7eylA 260w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_320/public/media/images/2022-04/pupillary-block.jpeg?itok=sGQxifwd 320w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_400/public/media/images/2022-04/pupillary-block.jpeg?itok=UeSqhizg 400w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/images/2022-04/pupillary-block.jpeg?itok=coNmVJlR 450w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_520/public/media/images/2022-04/pupillary-block.jpeg?itok=I529jr6Y 520w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_640/public/media/images/2022-04/pupillary-block.jpeg?itok=h-oScqDY 640w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_800/public/media/images/2022-04/pupillary-block.jpeg?itok=1y4WtMaz 800w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/images/2022-04/pupillary-block.jpeg?itok=_ihXgS6p 1040w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/images/2022-04/pupillary-block.jpeg?itok=GzqV7Ehn 1280w)
Pupillary block glaucoma may commonly occur secondary to:
- Aphakia or pseudophakia with either anterior vitreous displacement, dislocated anterior or posterior intraocular lens, or pupillary capture by intraocular lens implant
- Ectopia lentis
- Phacomorphic glaucoma due to cataractous lens intumesence
Management
- Anti-glaucoma therapy (i.e. aqueous suppressant therapy) initially
- Miotic drops may be helpful to eliminate the pupillary block / iris bombe
- Surgical therapy often needed (procedures may include laser iridotomy, laser iridoplasty, surgical iridectomy, or glaucoma filtering surgery)
![Dislocation of a posterior chamber intraocular lens resulting in the formation of pupillary block glaucoma. Note the dense fibrinous material/membrane covering almost the entire pupil.](https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_200/public/media/images/2022-04/pupillary-block-2.jpeg?itok=yrrbGQc2 200w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_260/public/media/images/2022-04/pupillary-block-2.jpeg?itok=fwLDFTce 260w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_320/public/media/images/2022-04/pupillary-block-2.jpeg?itok=x8SV_cjG 320w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_400/public/media/images/2022-04/pupillary-block-2.jpeg?itok=Obks_Z-k 400w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/images/2022-04/pupillary-block-2.jpeg?itok=SS6pbgkk 450w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_520/public/media/images/2022-04/pupillary-block-2.jpeg?itok=DyK9ideg 520w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_640/public/media/images/2022-04/pupillary-block-2.jpeg?itok=qICWgv79 640w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_800/public/media/images/2022-04/pupillary-block-2.jpeg?itok=SGlBtbs- 800w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/images/2022-04/pupillary-block-2.jpeg?itok=qSlRz36q 1040w, https://www.vagelos.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/images/2022-04/pupillary-block-2.jpeg?itok=uacTr1Qm 1280w)